Friday, September 20, 2013

How can high cholesterol affect vision?

September is National Cholesterol Education Month, it is fitting that we discuss the impact that cholesterol can have on your eyes. High cholesterol is so common, and many patients ask us about how this relates to eyes and vision.

High cholesterol levels in the blood cause a buildup of plaque in the arteries throughout the body over time. This can lead to narrowing of the arteries, thus reduces blood flow. Small blood clots then can lead to complete loss of blood flow to organs and tissues such as heart muscle (heart attack, myocardial infarction, angina), brain tissue (stroke) and lower extremities for example. Other risk factors such as Diabetes and Hypertension can increase the chances of blood vessel diseases. The small arteries and veins of the retina and optic nerve can become closed by blood clots also, which can lead to significant loss of vision. Symptoms of a retinal artery occlusion can be sudden, painless loss of central or peripheral vision in one eye.

Cholesterol in the bloodstream tends to accumulate in the cornea, the clear dome-shaped lens at the front of the eye. This appears as a white or gray ring around the peripheral cornea, making the iris color appear lighter, grayer or bluish. This can be quite prominent in some people. As we age, there is nearly always some of this appearance of Corneal Arcus, but when it is prominent or occurs at young ages (i.e.  50 years), it can indicate high cholesterol. This never affects the vision and we usually see some Corneal Arcus as a normal finding in patients over 50 years old.

Cholesterol material also appears around the eyes in some patients as fatty deposits of yellow material under the skin of the eyelids. This is called Xanthelasma. These are benign lesions and do not require removal. As with Arcus, these can occur with normal blood cholesterol levels also.

It is important to manage cholesterol levels with your primary care doctor to maintain good health of blood vessels throughout the body. A combination of diet management, exercise and medications is generally very effective for controlling cholesterol levels.
-R.Scott Hoffman, MD

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