Windows into our hearts

Damaged: Diabetic retinopathy of the left eye. — Health Ministry

BESIDES being the “windows to the soul” as it’s poetically said, our eyes can also be regarded as windows to our heart. Though these two vital organs may not seem to be linked, they actually share many similar features, particularly in the aspects of their blood vessels.

The network of blood vessels at the back of the eye is closely related to heart health. These blood vessels are the only vasculature in the human body that is visible without requiring invasive methods of investigation. An examination with careful viewing of the inner and outer part of the eye often can reveal early signs of cardiovascular disease (which may later present acutely as a heart attack or stroke).

Based on the results of the National Health and Morbidity Survey 2019, three in 10 Malay-sians have high blood pressure. In the early stage, high blood pressure – or hypertension – typically has no warning symptoms. Thus, many people are not aware they suffer from hypertension until they develop end-stage organ damage.

An eye doctor, however, may be able to discover early clues to problems by recognising changes in the eye’s blood vessels or small bleeding spots at the back of the eye. Sometimes, even a blocked artery with a blood clot leading to an impending eye stroke can be picked up by an experienced ophthalmologist.

It is estimated that two out of 10 adults in Malaysia have diabetes. High blood sugar levels may damage the tiny blood vessels of the eye and cause leakage of fluid into the surrounding tissue. These conditions are known as diabetic retinopathy and diabetic macular oedema respectively; if untreated, they can lead to vision impairment or, ultimately, blindness.

Ideally, these reversible conditions should be identified before visual loss occurs. For type 2 diabetes patients, diabetic retinopathy screening is recommended and should be carried out annually if not more often.

Notably, four in 10 Malaysian adults have raised total cholesterol levels, with one in four people unaware of it. However, the condition may occasionally manifest as small, yellowish soft bumps (called xanthelasma palpebrarum) around the eyelids.

These aesthetically unpleasant bumps rarely affect our vision but they may indicate a high cholesterol problem. Individuals who have such eye plaques should get their cholesterol levels checked.

In short, early detection and subsequent treatment of risk factors of cardiovascular disease – namely high blood pressure, diabetes, high cholesterol levels – via an eye examination can reduce our risks of getting a heart attack or stroke in the near future.

In line with the upcoming (Sept 29) World Heart Day’s theme of “Use heart for every heart” and World Sight Day’s (Oct 13) theme of “Love your eyes”, every Malaysian aged 40 years and above should make a commitment to doing a medical checkup yearly with a comprehensive eye examination. For the B40 (low income) group aged 40 years and above, PeKa B40 (Health Care Scheme of the B40 Group), a free health screening service offered through the health protection scheme is available (details at pekab40.com.my).

DR YAP JUN FAI

PROF DR MOY FOONG MING

DR LIM YIN CHENG

DR ALAN FONG

Dr Yap is with the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, and the Department of Public Health, Universiti Malaya Medical Centre; Dr Moy and Dr Lim are with the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya; and Dr Fong is with the National Heart Association of Malaysia.