Melissa, a 30-year-old educator, came to the emergency department with a sudden onset of double vision. She had not been in an accident or suffered any trauma and had never experienced this symptom before. However, she noted that a few months earlier, the vision in one of her eyes had become blurred and then returned to normal shortly after. She told herself it was a sign of fatigue after a period of intense work on a screen.
After some basic optometric tests, then more advanced tests of visual perception, the visual episodes were thought to be related to multiple sclerosis. Melissa was then referred to a neuro-ophthalmology specialist who confirmed the diagnosis, and she was quickly treated.
Is Melissa’s case unique? Over my 30 years working as an optometrist, I’ve seen many patients with different vision and eye health problems, the cause of which turned out to be an illness they didn’t know they had.
As a professor at the School of Optometry at the Université de Montréal, I teach students that certain ocular symptoms can be linked to general health problems. Optometrists are trained to identify the various diseases that can manifest themselves through the eyes and to work with other health professionals to manage them.
Diabetes
Because diabetes will affect almost 8% of the population by 2030, screening is a crucial issue. However, it is estimated that diabetes is not generally diagnosed until six to 13 years after its onset. An eye health examination can shorten this delay since it is often possible to identify characteristic lesions of the disease at the back of the eye before other symptoms of diabetes appear.
Early diagnosis is crucial since within five years of diagnosis (i.e., 11 to 15 years after the onset of diabetes), 25% of patients with Type 1 (juvenile diabetes) and 40% of those with Type 2 (adult diabetes) who are treated with insulin will develop eye lesions that can have a major effect on their vision. Early identification and rigorous monitoring of eye health significantly reduces the risk of blindness, which can happen when the disease is not treated.
Unmasking the silent killer
If diabetes affects a significant number of patients without them knowing it, what can be said about high blood pressure and high cholesterol? These two conditions significantly increase the risk of coronary heart disease or stroke in our societies.
The eye is the only place in the human body where blood vessels can be seen without having to make an incision or use invasive techniques.
- High blood pressure (known as the silent killer) can be seen by crushing of vessels and very specific signs on the retina.
- Hypercholesterolemia creates cholesterol deposits inside the vessels.
- Atherosclerosis is associated with Hollenhorst plaques, also visible inside the vessels.
- Cholesterol can also be seen in the cornea (lipid arc) or in the adnexa (xanthelasma).
In all these cases, very often the symptoms experienced by the patient are so few, or progress so slowly, that he or she considers them almost normal.
Normotensive or open-angle glaucoma
The absence of symptoms is also the norm for glaucoma. This pathology of the optic nerve is usually associated with excessive production of aqueous humor in the eye or a deficit in its evacuation.
The pressure inside the eye then increases and through different mechanisms leads to the loss of nerve fibers in the nerve. The visual field narrows very slowly (and therefore can go unnoticed), so the person ends up with tunnel vision after several years.
By the time this loss of vision affects them, it is often late, so the damage to the optic nerve can be very extensive. This damage is mainly ocular, although it can also be induced by the effect of certain drugs (such as cortisone).
Normotensive glaucoma is of a completely different nature. In this case, the pressure inside the eye remains normal but the nerve is still damaged. The mechanisms at play are different from those in chronic open-angle glaucoma.
Normotensive glaucoma is often associated with low blood pressure or conditions such as sleep apnea. If it is present, the patient must be referred to a family doctor for a thorough investigation.
The disease of the century
Because cancer is becoming so widespread and is expressed in so many ways, we call it the disease of the century. Cancers that affect the eye (retinoblastoma) can also cause metastases to the lungs and liver.
Here again, the disease often develops without symptoms until it is too late. So early detection is crucial, because the patient’s very survival is at stake.
Other types of asymptomatic retinal pigment (shaped like a bear’s paw) may be associated with cancer of the colon, which has a very negative prognosis if management is delayed.
A simple visual field measurement may reveal abnormalities that some patients are unaware of, or that they consider so benign they don’t bother to report them. However, many visual field abnormalities hide brain tumors, such as pituitary adenoma, or nerve fibers compressed by blood vessels.
Abnormal eye movements, asymmetric pupillary responses, sudden reading problems or the appearance of diplopia are all yellow flags that require further ocular and neurological investigation.
Rather than the mirror of the soul, the eyes become an open window on our overall health. That makes regular consultations with an optometrist more important than ever, even when there are no symptoms. Many disorders can be detected and treated to either minimize illnesses or prevent them altogether.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
News
New Blood Test Detects Alzheimer’s and Tracks Its Progression With 92% Accuracy
The new test could help identify which patients are most likely to benefit from new Alzheimer’s drugs. A newly developed blood test for Alzheimer’s disease not only helps confirm the presence of the condition but also [...]
The CDC buried a measles forecast that stressed the need for vaccinations
This story was originally published on ProPublica, a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. ProPublica — Leaders at the Centers for Disease Control and Prevention [...]
Light-Driven Plasmonic Microrobots for Nanoparticle Manipulation
A recent study published in Nature Communications presents a new microrobotic platform designed to improve the precision and versatility of nanoparticle manipulation using light. Led by Jin Qin and colleagues, the research addresses limitations in traditional [...]
Cancer’s “Master Switch” Blocked for Good in Landmark Study
Researchers discovered peptides that permanently block a key cancer protein once thought untreatable, using a new screening method to test their effectiveness inside cells. For the first time, scientists have identified promising drug candidates [...]
AI self-cloning claims: A new frontier or a looming threat?
Chinese scientists claim that some AI models can replicate themselves and protect against shutdown. Has artificial intelligence crossed the so-called red line? Chinese researchers have published two reports on arXiv claiming that some artificial [...]
New Drug Turns Human Blood Into Mosquito-Killing Weapon
Nitisinone, a drug for rare diseases, kills mosquitoes when present in human blood and may become a new tool to fight malaria, offering longer-lasting, environmentally safer effects than ivermectin. Controlling mosquito populations is a [...]
DNA Microscopy Creates 3D Maps of Life From the Inside Out
What if you could take a picture of every gene inside a living organism—not with light, but with DNA itself? Scientists at the University of Chicago have pioneered a revolutionary imaging technique called volumetric DNA microscopy. It builds [...]
Scientists Just Captured the Stunning Process That Shapes Chromosomes
Scientists at EMBL have captured how human chromosomes fold into their signature rod shape during cell division, using a groundbreaking method called LoopTrace. By observing overlapping DNA loops forming in high resolution, they revealed that large [...]
Bird Flu Virus Is Mutating Fast – Scientists Say Our Vaccines May Not Be Enough
H5N1 influenza is evolving rapidly, weakening the effectiveness of existing antibodies and increasing its potential threat to humans. Scientists at UNC Charlotte and MIT used high-performance computational modeling to analyze thousands of viral protein-antibody interactions, revealing [...]
Revolutionary Cancer Vaccine Targets All Solid Tumors
The method triggers immune responses that inhibit melanoma, triple-negative breast cancer, lung carcinoma, and ovarian cancer. Cancer treatment vaccines have been in development since 2010, when the first was approved for prostate cancer, followed [...]
Scientists Uncover Hidden Protein Driving Autoimmune Attacks
Scientists have uncovered a critical piece of the puzzle in autoimmune diseases: a protein that helps release immune response molecules. By studying an ultra-rare condition, researchers identified ArfGAP2 as a key player in immune [...]
Mediterranean neutrino observatory sets new limits on quantum gravity
Quantum gravity is the missing link between general relativity and quantum mechanics, the yet-to-be-discovered key to a unified theory capable of explaining both the infinitely large and the infinitely small. The solution to this [...]
Challenging Previous Beliefs: Japanese Scientists Discover Hidden Protector of Heart
A Japanese research team found that the oxidized form of glutathione (GSSG) may protect heart tissue by modifying a key protein, potentially offering a novel therapeutic approach for ischemic heart failure. A new study [...]
Millions May Have Long COVID – So Why Can’t They Get Diagnosed?
Millions of people in England may be living with Long Covid without even realizing it. A large-scale analysis found that nearly 10% suspect they might have the condition but remain uncertain, often due to [...]
Researchers Reveal What Happens to Your Brain When You Don’t Get Enough Sleep
What if poor sleep was doing more than just making you tired? Researchers have discovered that disrupted sleep in older adults interferes with the brain’s ability to clean out waste, leading to memory problems [...]
How to prevent chronic inflammation from zombie-like cells that accumulate with age
In humans and other multicellular organisms, cells multiply. This defining feature allows embryos to grow into adulthood, and enables the healing of the many bumps, bruises and scrapes along the way. Certain factors can [...]
