Eye Exams: A Window To Systemic Health
It is important to get regular eye exams so that your eye doctor can test your visual acuity, measure your intraocular pressure to assess your risk for glaucoma, and examine the lenses of your eyes to evaluate them for cataract formation. In addition to these routine assessments, your eye doctor may also be looking for clues inside your eyes that may reveal chronic illness. Here are some ocular manifestations that your eye examination may reveal that may indicate the presence of a systemic illness.
Scleral Icterus
The white part of your eyes is known as the sclerae. When you are tired or have been exposed to irritants such as smoke, dust, animal dander, or air pollution, you may develop scleral redness or notice enlarged blood vessels in the whites of your eyes. These signs are often temporary and respond well to lubricating eye drops and avoidance of allergy triggers. If, however, your eye doctor notices yellowing of the sclerae, also known as scleral icterus, they may inquire about your liver health.
Scleral icterus may be the result of high levels of bilirubin in the blood. Bilirubin is a yellow compound most commonly found in bile. Elevated blood levels of bilirubin may be the result of cirrhosis of the liver, fatty liver disease, or even a liver infection such as hepatitis. If you have scleral icterus, your optometrist will refer you back to your primary care doctor for further testing.
Subconjunctival Hemorrhage
A subconjunctival hemorrhage happens when a small blood vessel inside your eye breaks, which may cause blood spots to appear on the sclera. It is almost always caused by a benign factor such as rubbing your eyes too hard, excessive straining caused by sneezing or coughing, eye irritation caused by contact lenses, and from taking certain medications such as aspirin and prescription anticoagulants. In some cases, however, a subconjunctival hemorrhage may be caused by an underlying systemic condition such as a blood platelet disorder.
If your eye doctor notices blood spots on your sclera, they may ask you about your medications and if your eyes have been irritated. While in most cases, subconjunctival hemorrhages are harmless, your optometrist may recommend visiting your primary care physician if you keep getting them or if they do not resolve over time.
If you develop scleral icterus or a subconjunctival hemorrhage, see both your optometrist and regular physician. When you work with both of your healthcare providers, the cause of your eye symptoms can be determined faster so that a treatment plan can be quickly implemented.
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