DR. MARIANNA POCHELLI

The eyes may be the window to the soul, but they may also prove to be a reliable indicator for specific health symptoms. Systemic illnesses such as diabetes, cardiovascular disease, and even specific problems related to the thyroid, liver and even cancer may all be detected through specific characteristics in and around the eye.

“The eye is a unique window into health,” says ophthalmologist Andrew Iwach, spokesperson for the American Academy of Ophthalmology (AAO) and executive director of the Glaucoma Center of San Francisco. “It’s the only place in the body where, without surgery, we can look in and see veins, arteries and a nerve [the optic nerve].”

The list of systemic diseases that can have ocular manifestations is a long one; in addition to diabetes and cardiovascular disease, it includes aneurysms, HIV, cancer, and rare hereditary diseases. The list is one reason eye experts recommend periodic eye exams.

Some ocular manifestations of systemic disease can be seen only by a trained specialist during the course of an eye exam. Others are plain for all to see. Here are 12 of the most common eye signs and what they might be saying about your health:

1. RED OR BLOODY EYES
Could be: High Blood pressure
The eye’s transparent outer layer, called the conjunctiva, is nourished by numerous tiny blood vessels. If these burst, blood may pool on the white of the eye (sclera). High blood pressure can make these blood vessels appear twisted – or even cause them to burst so the eyes look red. A quarter of adults with high blood pressure don’t know they have the condition, which can cause strokes. A subconjunctival hemorrhage, as it is known among doctors, can be caused by a blow to the eye but in most cases has no obvious cause. In rare instances, a subconjunctival hemorrhage can be a sign of severe high blood pressure or a platelet disorder, which can interfere with clotting.

2. BULGING OR BUG EYES
Could be: Thyroid Disease
Though prominent eyes may simply be a family trait, eyes that appear to bulge may be evidence of thyroid disease. Abnormal levels of thyroid hormone cause tissues surrounding the eye to swell, making it appear that the eye is bulging. The most common cause of protruding eyes is this overactivity of the thyroid gland. One way to tell if an eye is bulging is to see whether there’s any visible white part between the top of the iris and the upper eyelid, because normally there shouldn’t be.

3. YELLOW EYES
Could be: Diabetes
Liver conditions, including hepatitis and cirrhosis, can turn the whites of your eyes yellow — a symptom which requires immediate medical attention. The colour is caused by bilirubin, a chemical created by the breakdown of hemoglobin, the oxygen-carrying molecule inside red blood cells. The medical term for yellow eyes is scleral icterus — even though it’s not actually the scleras that turn yellow, but the conjunctiva.

4. RINGS AROUND THE CORNEA
Could be: High Cholesterol
Some people develop a gray ring around the edge of the cornea. The ring, which doctors call arcus senilis, often goes hand in hand with high cholesterol and triglycerides – and an increased risk for heart attack and stroke. Anyone who has the condition should have a blood test to check for elevated blood lipids – especially people under age 60.
A rare hereditary disorder known as Wilson’s disease can also cause copper to accumulate in various tissues, including those in the brain and liver. Copper deposits sometimes form on the inner surface of the cornea (though they appear to a casual observer to be on the iris, the colored disk that surrounds the pupil). These “Kayser-Fleischer rings” are themselves harmless. But without appropriate treatment, Wilson’s disease can be fatal.

5. DROOPY EYELID
Could be: Bell’s Palsy or Stroke
This condition, known among doctors as ptosis, can be simply a sign of aging. But in rare cases it is evidence of a brain tumor or a neuromuscular disease known as myasthenia gravis (MG), an autoimmune disorder that weakens muscles throughout the body. A drooping eye can also indicate Bell’s Palsy, a temporary facial paralysis. It can also be a symptom of a stroke, especially if the speech is slurred.

6. CLOUDY EYES
Could be: Cataracts
A white reflex in the pupil could be the sign of a congenital cataract, intraocular tumor (retinoblastoma) or a parasitic infection (toxocara canis). The condition, which can be corrected with surgery, is most common in older people. Cataracts that arise in younger people can have a variety of causes, including tumors and diabetes, as well as side effects from certain medications.

7. PALE OPTIC NERVE
Could be: Multiple Sclerosis or Brain Tumour
The optic nerve, which transmits information from the retina to the brain, is visible at the rear of the eye to an optician. The nerve is supposed to be pink. A pale optic nerve can be an early manifestation of MS or evidence of a brain tumour. This can only be viewed by a specialist.

8. INCREASING GUNK IN THE EYE
Could be: Scalp Dandruff or Acne Rosacea
Blepharitis–inflammation of the eyelids, especially at the edges–can have several causes. Two of them, surprisingly, are conditions better associated with other body parts: scalp dandruff and acne rosacea (which causes flushed red skin, usually in the faces of fair-skinned women at midlife). The eyes may also feel irritated, as if specks have gotten in them. They may burn, tear or feel dry. The crusty debris tends to gather in the lashes or the inner corners of the eyes or even on the lids.

9. DIFFERENT SIZED PUPILS
Could be: Stroke or Tumour
Healthy pupils are around the same size and react similarly to light. If one pupil is bigger than the other, or if one pupil shrinks less, or more slowly, on exposure to light, there could be an underlying health problem. Possibilities include stroke, brain or optic nerve tumor, brain aneurysm, syphilis, and multiple sclerosis (MS). Finally, many medications can cause the pupils to appear unusually small or large.

10. DIFFERENT COLORED EYES
Could be: Glaucoma or Inflammation
Also called heterochromia iridis, this condition is usually inherited. A change in one color may be due to bleeding, a foreign body in the eye, glaucoma, inflammation in the eye or other conditions such as Waardenburg syndrome or neurofibromatosis.

11. DISAPPEARING EYEBROWS
Could be: Thyroid Disease
But when the outer third of the brows (the part closest to the ears) starts to disappear on its own, this is a common sign of thyroid disease–either hyperthyroidism (overactive thyroid gland) or hypothyroidism (underactive thyroid gland). Brows tend to thin with age naturally. But with thyroid disease, the brow-hair loss isn’t evenly distributed; it’s a selective dropout on the ends. There’s usually a loss of hair elsewhere on the body, too, but the brows are so prominent, it’s often noticed here first. Early graying is a related sign of a thyroid problem. Women are more often affected than men, and hyperthyroidism especially strikes women in their 20s and 30s.

12. A STYE THAT WON’T GO AWAY
Could be: Cancer
The vast majority of the time, a small, raised, often reddish bump along the inner or outer eyelid margin is just an unsightly but innocuous stye (also called a “chalazion”). But if the spot doesn’t clear up in three months, or seems to keep recurring in the same location, it can also be a rare cancer (sebaceous gland carcinoma). Actual styes are plugged-up oil glands at the eyelash follicle. Fairly common, they tend to clear up within a month. A cancerous cyst that mimics a stye, on the other hand, doesn’t go away. (Or it may seem to go away but return in the same spot.) Another eyelid cancer warning sign: Loss of some of the eyelashes around the stye.

Any of the above signs and symptoms merit immediate attention by your health practitioner.

Dr. Marianna Pochelli is a Doctor of Naturopathic Medicine specializing in the treatment of disease through superfoods and herbal strategies. She actively promotes detoxification, colon cleansing, and a vegetarian lifestyle using living foods as a platform to health.