What Your Eyes Can Tell Us About Your Heart

When we talk about eye health, most people think about glasses, reading, or whether their eyesight has changed. But one of the most fascinating parts of my job as an optometrist is this:

Your eyes can tell us a surprising amount about your heart and blood vessels.

The eyes: a window to your blood vessels

At the back of your eye is the retina. It’s the only place in the body where we can directly see blood vessels without surgery.

When we look at your retina, we’re not just checking your vision, we’re looking at the health of your circulation. Changes in these tiny vessels can reflect what’s happening elsewhere in the body, including the heart and brain.

Blood pressure and your eyes

High blood pressure doesn’t always cause symptoms, but it can quietly damage blood vessels over time.

In the eyes, we may see:

• Narrowed or stiffened blood vessels

• Tiny leaks or bleeding

• Swelling of the optic nerve in severe cases

  
  

These same processes affect the heart, kidneys, and brain. Sometimes, eye changes are the first clue that blood pressure isn’t well controlled.

A side-by-side look at a healthy retina compared to one affected by severe high blood pressure. In hypertensive eye disease, we commonly see bleeding, narrowed or damaged blood vessels, areas of leakage, and white “fluffy” spots called cotton wool spots—signs that the circulation is under strain.

Cholesterol and circulation

Cholesterol plaques don’t just affect large arteries like the coronary arteries, they can impact small vessels too.

In the eyes, this may show up as:

• Reduced blood flow to the retina

• Sudden vision changes if a vessel becomes blocked

  
  

Again, the eye findings can mirror cardiovascular risk elsewhere in the body.

The important point? Eye damage and heart disease often progress together.

Catching retinal changes early gives us a chance to intervene sooner, sometimes before symptoms appear.

Why regular eye exams matter (even if you see well)

Many people say, “My vision is fine, I don’t need an eye test.” But vision is only part of the story.

A comprehensive eye exam can:

• Detect early vascular changes

• Prompt referral back to your GP for blood pressure, cholesterol, or diabetes review

• Act as another layer of protection for your overall health

  
  

Think of it as preventative care, not just a vision check.

The big picture

Your eyes don’t exist in isolation. They’re connected to your heart, your brain, and your overall wellbeing. Sometimes, looking into the eyes helps us spot health issues early before they become bigger problems.

And that’s why eye care is about much more than seeing clearly.