Eye Spy: What Your Eyes May Be Telling You

By: Dr. Victor Marchione | Eye Health | Wednesday, March 26, 2014 - 11:00 AM


Dr. Victor Marchione shares his views on eye health

Red and swollen, or tearing up when summer allergies come on strong? Your eyes need some TLC – and regular checkups, just like your blood pressure.

In fact, an eye doctor, your friendly optometrist, is a VIP when it comes to your health. She’s the first health professional to detect systemic disorders in people, such as diabetes, high blood pressure and even multiple sclerosis. Just by looking into your baby blues (hazels, greens, browns, etc.) for a routine eye exam. So beyond eye diseases like glaucoma and cataracts, big worries like heart disease can be spotted oftentimes long before symptoms appear.

You really don’t need a psychic when it comes to your health; get your eyes checked and go see your doctor when you notice anything of concern. I always tell my patients that early detection can make all the difference.

In fact, the list of systemic diseases that can show in the eyes is a long one; in addition to diabetes and cardiovascular disease, it includes aneurysms, cancer, HIV and rare hereditary diseases. Hence the recommended need for periodic eye exams.

A good friend of mine told me a story of how an eye exam discovered pressure in the back of the eye of one of his childhood friends. That pressure turned out to be a brain tumor, meaning early detection made treatment possible.

Eyes are the only part of the body where it is possible to see a bare nerve, a bare artery, and a bare vein without taking more invasive measures like surgical cutting. And the disease processes we see occurring in the eye are likely occurring in the rest of the body. While you may be considering the cosmetics of the eyes – adding some impact with colored contact lenses or, for the ladies, eyelash extensions from your esthetician or the most flattering eye pencil to create a vixen “smoky eye,” we physicians are looking at the eyes as an amazing diagnostic tool.

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Everyone should have a comprehensive eye exam as early as age five, specialists say, but make sure you schedule exams regularly after age 40, especially if you have a family history of eye problems. After 40, the eye’s naturally-occurring nutrient protectors, including the carotenoids lutein and zeaxanthin, start to diminish, setting you up for vision problems. Also of concern, symptoms of eye troubles can be silent, where a specialist is essential to make the diagnosis. Anyone who is having eye trouble, though, should see a doctor right away.

Now, step up to your bathroom mirror, with all lights full power, and look closely at your eyes. Here’s my guide to your eye health, outlining the most common eye signs and what they might be saying about your health.

Most Common Eye Signs To Decode Your Health

Dark Spot On The Iris, Floaters In Your Vision Field

Are you experiencing some odd symptoms? Blurry vision, sudden loss of vision or those pesky floater spots or light flashes in your field of vision? Even a dark spot growing on your iris or a change in the size or shape of the pupil. These symptoms could mean eye cancer, so get tested.

Erratic Eye Movements

There’s no definitive test for early Alzheimer’s detection, but some are in development. One tracks subtle eye flickers known as saccadic movements. When people show signs of memory loss or other cognitive difficulties, these eye movements can become more erratic and slower, making them a possible indicator of the disease. Further, researchers at Cedars-Sinai Medical Center in Los Angeles are conducting a clinical trial to see if an eye test for beta amyloid proteins in the retina, found in people with Alzheimer’s, can identify those who are starting to develop the disease but show no symptoms.


Oy! That red, itchy, leaking eye with the swollen eyelids? Those are the telltale signs of pinkeye, also called conjunctivitis, a common condition that is irritating but unlikely to cause any long-term damage. That said, you want to have it detected promptly and treated. With pinkeye, you’ll know you have something. It’s uncomfortable, with that bothersome feeling of something in the eye. Kids describe it as feeling sand in their eyes. It’s not sand. The redness and inflammation on the inner part of the eyelids and the clear membranes covering the whites of the eyes are caused by a virus or a bacterial infection, although chemical agents or allergies can also play a role.

The problem is pinkeye can be contagious! You need to be on lock-down for the first 24 hours and see your doctor. Use a cold or warm compress, and use a different washcloth for each eye to prevent the spread of infection. Use fresh linens and towels daily – and don’t share your towels – disinfect your doorknobs, sinks and countertops, and throw away any eye makeup you used while infected. Believe me, you don’t want the return of pinkeye.

The general rule is bacterial pinkeye is treated with antibiotic eye drops, pills or ointment to clear the infection. In most viral pinkeye cases, you have to relax and let the virus run its course, usually four to seven days, and remember that you are contagious while the symptoms last. When it comes to allergic pinkeye symptoms, they should improve once the source is removed and the allergy is treated. For chemical pinkeye, prompt washing of the affected eye is crucial, along with seeking medical help.

Take note: Persistent pinkeye can be a sign of an underlying illness in the body, most often rheumatic diseases, such as rheumatoid arthritis and lupus, and occasionally inflammatory bowel diseases.

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Bloody Eye

A bloody eye can be frightening. It’s a sign you’re actually bleeding underneath the eye’s transparent outer layer, called the conjunctiva. This outer layer is nourished by tiny blood vessels that you can’t see – until they burst. When that happens, blood may pool on the white of the eye. The condition is called subconjunctival hemorrhage, and can be caused by a blow to the eye. Mixed martial arts fighters might be a little more familiar with this condition than the rest of us. But in most cases, subconjunctival hemorrhage has no obvious cause. In rare instances, it can be a sign of severe high blood pressure or blood platelet disorder, which can interfere with clotting. See your doctor if the condition persists.

Droopy Eyelid

Sometimes called “lazy eye,” the drooping or falling eyelid is a condition known as ptosis. It can be worse at night or in early morning when the eyelid muscles can be tired. Sometimes, it is simply a sign of aging, so there’s not much you can do! But in rare cases it is evidence of a brain tumor or a neuromuscular disease known as myasthenia gravis (MG). MG is an autoimmune disorder that weakens muscles throughout the body. See your doctor.

Swollen Eyelids

Odd swelling on the eyelids, along the lash line where the lashes sit, and dry eyes that just won’t tear? Don’t sit through The Notebook if you can’t break down and sob. That’s part of the movie experience. This could be blepharitis, a common eye issue that accounts for 5 percent of eye problems that GPs come across. While the swelling and dry-eye can be uncomfortable, it’s not usually serious and vision is rarely affected. Cold compresses please!

Thickened Eyelid

This one’s very rare. A deformed noticeably thickened eyelid can signal neurofibromatosis. A mouthful to pronounce, this is a hereditary disorder where tumors have developed along the eye’s nerve fibers. Remember the “Elephant Man,” Joseph Merrick, the 19th century Englishman? Experts long considered his deformations the result of neurofibromatosis; now his challenges have been attributed to another rare condition known as Proteus Syndrome. Still, this hereditary disorder should be diagnosed by a doctor.

Yellow Jaundiced Eyes

Jaundice is easily detected in the whites of the eyes (the scleras) since they turn a sickly yellow. Not so pretty! The cause can signal diseases of the liver, including hepatitis and cirrhosis. The telltale color is caused by the buildup of bilirubin, a compound created by the breakdown of hemoglobin, the oxygen-carrying molecule inside red blood cells. The National Institutes of Health (NIH) notes that patients who have jaundice usually have both yellow-colored skin and eyes. So check your skin tone, too, for that yellow tint. Mild cases go away without treatment, but if it persists, see your doctor for treatment.

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Bulging Eyes

Yes, some eyes are more prominent than others, thanks to family genetics, but those super-bulging eyes may be a sign of thyroid disease. It can hit men as well as women, and often poor sleep and stress are the culprits. The disease is marked by abnormal levels of thyroid hormone; it causes tissues surrounding the eye to swell, making it appear as though the eye is bulging. Again, get it checked by your doctor.

Color Chameleon

Beyond those dramatic colored contact lenses! Also called heterochromia iridis, different colored eyes is hereditary. Thanks Dad! However, if it suddenly comes up, a change in color could mean bleeding, something foreign in the eye, inflammation in the eye, glaucoma or other conditions.

Pupil Abnormalities

Look really close. Healthy pupils are, for the most part, symmetrical; they’re usually the same size, and show the same reaction with exposure to light. However, if one pupil is larger than the other, or it shrinks less, or more slowly when light hits, this could spell trouble. Some medications and illicit drugs can cause the pupils to appear unusually large or small. But get this checked! Underlying medical problems that cause pupil abnormalities include stroke, brain or optic nerve tumor, brain aneurysm, syphilis and multiple sclerosis (MS).

You see? Your eyes can say plenty! Take the time to monitor any changes or abnormalities and take action. Good proactive thinking, too, will help preserve your eye health and your vision. You know the drill: Eat a healthy, balanced diet including fatty fish and leafy greens, quit smoking, wear sunglasses and keep those screen breaks steady, whether it’s the laptop or the TV.

Yours in Good Health,

Dr. Victor Marchione

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