Can heart problems affect your eyes?

Heart problems can affect your eyes and have links to an increased risk of developing some eye diseases (Source: European Heart Journal). Cardiovascular disease is a term used for conditions that affect the heart and blood vessels all around the body, including the delicate blood vessels in the eye that supply blood to the retina at the back of the eye. These eye changes may be picked up in an eye exam and can be a warning sign of underlying heart disease.

Risk factors for heart problems and cardiovascular disease include diabetes, smoking, high blood pressure and high cholesterol. The impact on the eyes can be blurred vision, bleeding at the back of the eye, vision loss and increased risk of developing age-related macular degeneration and glaucoma (Sources: Ophthalmic Epidemiology, Glaucoma Research Foundation).

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Heart attack and eye symptoms

An eye exam could detect underlying coronary heart disease (CHD), the leading cause of heart attacks (Source: NHS). CHD causes atherosclerosis, a build-up of plaque from cholesterol and other products, creating a blockage in the blood vessels to the heart that can lead to a heart attack. However, CHD can be associated with changes in other blood vessels around the body, including the eyes.

If your optician or ophthalmologist detects changes to the blood flow through the delicate blood vessels in the eye, it may be a very early indication that you are at increased risk of coronary heart disease.

Congestive heart failure and your eyes

Congestive heart failure (sometimes referred to as heart failure) is when the heart becomes less effective at pumping blood, resulting in fluid gathering in the lungs and tissues around the body. If this fluid settles in the eyes, it can increase pressure and damage the optic nerve and blood vessels.

The best ways to prevent heart failure are:

  • Stop smoking
  • Be physically active
  • Eating a healthy, balanced diet
  • Maintaining a healthy body weight
  • Keeping stress and cholesterol levels down
  • Control medical conditions like diabetes and high blood pressure; take your prescribed medications and attend healthcare appointments (Source: JAMA Cardiology)

Blurry vision and chest pain

Heart disease and other medical conditions, like diabetes and high blood pressure, can damage the blood vessels in the eyes, making it harder for your eyes to focus, resulting in blurred or altered vision. Reduced blood supply also starves the eyes of oxygen, affecting vision. Visual disturbances, like blurred vision, that occurs alongside chest pain can be a sign of extremely high blood pressure (Source: Patient), heart attack or stroke; all medical emergencies that need urgent attention.

Bloodshot eyes and high blood pressure

High blood pressure (hypertension) can cause bloodshot eyes in a condition called hypertensive retinopathy. Every blood vessel in the body feels the effects of high blood pressure, and the tiny blood vessels in the white of the eyes can burst, making them look bloodshot. High blood pressure can also cause blood clots, damage to the retina, visual changes, vision loss and headaches. Lowering the blood pressure can resolve symptoms in mild cases, but more severe cases need further investigation and urgent review by a doctor (Source: National Library of Medicine).

Eye floaters and heart disease

An increase in floaters can occasionally indicate an eye condition called retinal vein occlusion, which is linked to heart disease. A vein behind the eye gets blocked (occluded) in this condition, causing a reduction in vision. Risk factors include raised eye pressure, high blood pressure and high cholesterol (Source: Patient).

There is also a link between heart disease, eye floaters and diabetes. Diabetes often leads to diabetic retinopathy, where damage to the blood vessels in the eyes caused by a high blood sugar results in visual disturbances like floaters and vision loss. People with diabetes are at greater risk of developing heart disease (Source: Diabetes UK), increasing their risk of vision changes and eye floaters due to one condition or the other, or a combination of both.

Signs of heart disease in eyes

Your eyes can reveal early signs of heart disease, and optometrists will look for these signs during routine eye exams. The eyes are the only place in the body where we can easily access visible blood vessels, and examining these vessels gives us an idea of the health of the whole vascular system.

Some of the tell-tale signs of heart disease include:

Heart disease and eye problems

Three significant risk factors for heart disease are high blood pressure, diabetes and high cholesterol levels. All three can cause eye conditions that can impact vision if left untreated.

Frequently asked questions

Conclusion

Some eye problems and heart problems are linked. The blood vessels in the eyes give us an idea of the state of the cardiovascular system and can be the first signs of underlying heart disease. Good eye care, a healthy lifestyle, regular eye exams and monitoring physical signs and symptoms can help protect your eye health. If you have a medical condition, a family history of heart problems, or any concerns about your eye or heart health, consult your GP or eye doctor.

Medically reviewed by: The Royal College of Ophthalmologists on 28/07/2022

Edited by: Nick Astbury FRCS FRCOphth FRCP
Clinical Associate Professor
LSHTM

The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.