Using Retinal Photography to Detect Risk for Stroke

6:31 PM

I was reviewing retinal photography with a patient today, and everything looked healthy.

A retinal hemorrhage tells us that blood flow has been compromised,
a huge red flag for blood pressure issues!
"Your blood vessels look excellent;  no hardening of the arteries, no cholesterol plaques, and no leaky capillaries.  And if your retinal vessels look this good, we know the rest of your body is likely having great blood flow as well."  I said.

"You mean the blood vessels in my eye will tell you about the rest of my body?  I never realized that!"

My patient left happy and amazed that she was getting such a thorough check up, but it took me a second to recover from the surprise that this was the first year that we had made such a connection between her eye and her systemic health.  She had been getting retinal photos for years, and never before really seen the true value; your doctor is looking at the health of your eye, but they are more importantly checking the health of your entire body by using the eye as a window inside.

Not surprising to optometrists and other health care professionals, but a new study out this month published in Hypertension reports that there is a strong correlation between hypertensive retinal changes and the risk for stroke.  Retinal photographs were tracked over a course of 13 years, and the results were as follows:
  • Mild Hypertensive Retinopathy (early changes like hardening of the arteries) had a 35% increased risk for stroke
  • Moderate or Severe Hypertensive Retinopathy (like bleeding inside the eye) had a 137% increased risk for stroke
If you have been diagnosed with high blood pressure or are just interested in getting a routine health check up, I cannot overemphasize the value of a comprehensive ocular examination.  Your eye care provider checks for glasses yes, but that is just one part of the exam.  A trip to your eye doctor can detect early signs of potentially life-threatening systemic conditions before they have a chance to destroy your life, all without ever drawing your blood or checking your blood pressure!  Get the word out; your eye exam is about way more than just your eyes.  It is just as important as your routine physical at checking your overall health.

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