Cholesterol and The Eye

8:40 PM

Have you had your systemic health checked lately?  For many people, the answer is no.  Luckily if you are getting routine eye exams, your eye doctor can detect early signs of systemic health issues like high cholesterol!  How can I see potential cholesterol issues in your eye?

Corneal Arcus: that ring of blue is really cholesterol!
photo via
1) Corneal Arcus

Have you ever noticed a faint white or bluish ring that appears to be around the iris (the pigmented part of the eye)?  I have even had patients come in stating that they think their brown eyes are turning blue because they see this change in the mirror.  Nope, your eyes are not getting bluer; they are getting more cholesterol-y. Arcus is a ring of cholesterol deposition in the cornea (the clear dome that lays over the iris).  In the elderly, this is typically a normal change, and does not necessarily mean you have high cholesterol issues.  If we see these changes in young patients (under 40), however, cholesterol levels should be checked!

2) Arteriosclerotic Changes

When your eyes are dilated or your retina is alternatively evaluated, your doctor is paying close attention to your retinal blood vessels.  The arteries in the eye (really arterioles because they are too small to be arteries technically) will express the same health changes that arteries in the rest of your body are undergoing, making the eye a great place to assess vascular health.  High cholesterol can cause hardening of the artery (causing a whitened artery appearance instead of the normal red). In more severe cases, there can even be plaques of cholesterol that block or limit blood flow.  This can even cause vision loss in severe cases.  If arteriole changes are noted, your doctor will suggest checking blood pressure, cholesterol, and other vascular issues and may even send a note with their findings to your primary care doctor.  In many cases, these changes may not have any visual symptoms, making their detection completely dependent on you getting a health examination.
Lipemia Retinalis:  severe whitening of the retinal vessels due to elevated cholesterol
photo via
A Hollenhorst plaque is a blockage of cholesterol that lodges within the retinal vasculature and obstructs flow via

3) Xanthelasma

Cholesterol can also build up as plaques on the eyelids, typically on the nasal aspects of the lid.  These areas look like elevated yellowish growths.  They can be removed by a surgeon, but may return if cholesterol levels remain uncontrolled.

Xanthelasma plaques via

Interested in learning more about how high cholesterol affects your entire body's health?  Check out this interactive resource from Healthline where you can learn more about cholesterol's toll on individual organs and body parts.  You can also head here to see what 100% of your daily value of cholesterol looks like.  Remember, your eye is a part of your body, and even if you don't have vision problems a yearly eye exam can help detect serious systemic health issues like elevated cholesterol, high blood pressure, and diabetes that could mean the difference in a happy, healthy life.

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  1. I have blue ring but cholesterol is normal

    1. Definitely not all people with corneal arcus have high cholesterol levels. In fact, I'm typically only recommending cholesterol testing when I find arcus if the patient is under 45. If you are older than that, arcus is typically just a sign of aging.