Heart Disease

February 6, 2013

February is American Heart month. Healthy eating, exercise, stress reduction, avoiding smoking, and routine exams with your primary care physician can be integral to your continued overall and heart health. What you may not know is that your retinal health can reflect the health of your heart as well. It is even possible that your eye doctor could be the first professional to notice and diagnose systemic diseases during a dilated examination. This is able to occur in ophthalmology because the eye is the only organ in which doctors can view blood vessels unobstructed. Dilated examinations are vital for continued eye health, and may even result in a systemic diagnosis which could save your life!

Strokes are both a heart and an eye concern. While you may be familiar with the damages associated with a stroke, including decreased mobility, speech changes, and death, you may not be aware of the damages caused by an occlusive, or stroke, event in the eye. There are multiple types of occlusive attacks, but they all generally share a common element: they can be severely detrimental to vision and can indicate a need for cardiovascular evaluation.

Two Types of Occlusive Eye Attacks

BRVO: Branch Retinal Vein Occlusion

  • Often characterized by a sudden onset of central vision defect or blurry vision.
  • Vision loss is usually unilateral, but can be bilateral
  • Treatment options can range from increased aspirin regimen to laser treatment to intraocular injections; these treatments are usually to reduce, prevent, or eliminate further complications from BRVO.

CRVO: Central Retinal Vein Occlusion

  • Often characterized by a sudden or gradual loss of vision, ranging from mild to severe; onset may be instantaneous but may take as long as a few weeks to present. This can progress to constant vision loss, a blind, painful eye or eyes, light sensitivity, and ocular redness.
  • Vision loss is usually unilateral, but can be bilateral.
  • Although there are treatment options available for CRVO, there is limited possibility for full recovery in an eye after this type of occlusive attack. Good visual recovery occurs in 10% or less than 10% of patients who suffer CRVO. Further, 10% of patients who suffer a CRVO in one eye will develop a CRVO in the other eye. Although there is no definitive prevention for CRVO, it is advised that good intraocular pressure control in patients with glaucoma and control of general systemic diseases may reduce risk.

Why Immediate Evaluation is Important if Vision is Lost

  • Vision may be saved, even partially
  • Occlusive attacks may suggest a need to evaluate medications
  • Occlusive attacks could indicate a need to have a cardiovascular evaluation
  • Though occlusive attacks are possible, vision may be lost to other reasons, some of which are easily treatable, provided immediate intervention occurs.