3 signs seen in the eyes that can predict a heart attack

It’s always said that the eyes are a window to the soul, but science now suggests they might also be a window to the heart. Researchers and doctors have begun paying closer attention to the tiny blood vessels in the retina, discovering some signs in the eyes that may actually help predict the risk of a heart attack.
Unlike the heart, the retina allows direct visualisation of the body’s microvascular system through a simple eye examination. And this is where it gets truly fascinating. Damage seen in the retinal vessels often mirrors the condition of vessels in the heart and brain, making the eyes a powerful predictor of cardiovascular health.

A large number of people with high blood pressure end up developing heart problems. It is therefore important that high BP patients are regularly screened for cardiovascular risk. Here, the risk should be assessed not just by measuring blood pressure levels but also by evaluating hypertension-mediated organ damage (HMOD). Hypertension over a long time also damages the blood vessels in the retina, leading to conditions such as hypertensive retinopathy and increasing the risk of vision loss. Hence, high BP patients should get themselves regularly screened for eye diseases. Let’s see how hypertension and eye diseases are linked.

Hypertensive eye disease includes many kinds of problems caused by high blood pressure. The most common one is called hypertensive retinopathy, where the blood vessels in the eye get damaged. Other commonly affected parts of the eye due to hypertension include the choroid, the vascular bed of the retina, and the optic nerve. This is known as hypertensive choroidopathy and hypertensive optic neuropathy, respectively.

Hypertensive eye disease can be caused by high blood pressure over a long period. In the last 30 years, research has taught us a lot more about the prevalence of hypertensive eye disease, its links to other health problems in the body, and its implications for a person’s overall health. This is especially true for hypertensive retinopathy. The blood vessels in the eye are quite similar in structure and function to those in the heart, brain, and kidneys. Because the tiny blood vessels in the retina can be easily seen without any complicated procedures, it becomes easier to study them. This has created a lot of interest among doctors and researchers to find better ways to check the health of these eye blood vessels, which can give clues about other diseases too.

Significant progress has been made with the use of adaptive optics and artificial intelligence in human sciences. These technologies have advanced the study of the ocular fundus. The eye is now a valuable site for diagnosing and predicting various disease conditions. Because of their accessible location, retinal microvessels allow easy detection of hypertension-related vascular damage. They have therefore been proposed as a window into the heart, kidneys, and brain health in patients with hypertension.

Retinal vein occlusion (RVO) may affect the central vein (CRVO) or a branch (BRVO), resulting in sudden, painless, unilateral vision loss of variable degree. Significant residual visual loss is frequent: it is one of the five leading causes of unilateral blindness. The diagnosis is usually made by fundus examination, which shows multiple haemorrhages, retinal and papillary oedema, and venous dilations in the territory of the occluded vein with or without swelling in the macula, known as macular oedema.
RVO are a significant cause of visual morbidity due to the disease per se and also due to its complications, mainly neovascularisation and glaucoma, both of which are potentially blinding conditions.

The small blood vessels in the heart, responsible for coronary circulation, are pretty similar to those in the brain and eyes. Studies have found that changes in the blood vessels of eye often detect diseases like high blood pressure and atherosclerosis (hardening of the arteries). For example, tiny bulges or leaks in the eye’s blood vessels can be signs of damage happening elsewhere in the body.

Research published in the Journal of the American Medical Association (JAMA) has revealed that changes in the retina can be an early warning sign of heart disease and how severe it might be. People with problems in these small blood vessels have a higher risk of heart attacks, heart failure, and strokes. The large MESA study also found that changes in the retina were linked to calcium build-up in the heart’s arteries and problems with blood flow in the heart. This means that regular eye checkups can help give clues about heart health.(Dr. Jay Goyal, Eye Surgeon, LASIK & Retina Specialist, Director Surya Eye Hospital, Mumbai)