Cholesterol and Your Eyes

High cholesterol, a condition of excess lipid fat in the body, can create a range of negative eye conditions, some harmful, some not.

Doctors suggest managing cholesterol levels by losing weight, eating healthier and exercising regularly.

Cholesterol and Eyes

Your body uses cholesterol, a waxy type of lipid fat, to manufacture vitamin D, steroid hormones and bile salts. Throughout the body, you have cholesterol moving as lipoproteins, which helps break down fat in the gut.

There are two types of cholesterol — high-density lipoprotein (HDL), or good cholesterol, and low-density lipoprotein (LDL), or bad cholesterol. When most people think of cholesterol, they automatically think of the heart and cardiovascular system.

But the effects of high cholesterol are far-reaching and can affect your eyes. Higher cholesterol concentrates are linked to vision complications ranging from benign and cosmetic to more serious conditions such as glaucoma and irreversible blindness. 

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How Does Cholesterol Affect Your Eyes?

Your retina is composed of an intricate network of nerves and blood vessels. When you have high LDL levels, cholesterol can travel to different parts of the body, including the blood vessels in the retina.

A 2019 study noted that high cholesterol may increase your chances of developing open-angle glaucoma. Left unchecked, this can lead to further vision complications, including vision loss.

Symptoms of High Cholesterol in the Eyes

Various high cholesterol symptoms can affect the eyes and the surrounding parts, therefore impacting your vision. Symptoms of high cholesterol in the eyes include:

• Xanthelasma                                     
• Arcus senilis
• Retinal vein occlusion
• Hollenhorst plaque

Xanthelasma

Xanthelasma is one of the most common eye symptoms directly linked to high cholesterol levels. It presents as a flat, or sometimes raised, yellow area around the eye or near the nose. Xanthelasma deposits are the result of cholesterol buildup under the skin.

The condition does not affect your eyesight and is most common in Asian females and people of Mediterranean descent. Some of the common risk factors that can lead to xanthelasma include:

• Obesity
• Diabetes
• Smoking
• High blood pressure

Arcus Senilis

Arcus senilis is another common condition that closely relates to high cholesterol levels in the body. It manifests as a white, blue, or light gray ring around the outside of the front eye. The color edges closer to the cornea as cholesterol levels rise.

The ring formation may start at the top or bottom of the cornea and then eventually form a full ring around the cornea. However, arcus senilis does not interfere with your vision. In addition, not everyone who develops the condition has high cholesterol, although you are more likely to get arcus senilis if you have high LDL levels.

Arcus senilis gets more common as you age, and you are more likely to develop the condition if you’re a man or of black descent. The condition can also appear in children and is known as arcus juveniles. In kids and younger adults, the condition is a warning sign of high cholesterol.

Retinal Vein Occlusion

The retina is a light-sensitive tissue at the back of the eye, and it receives its blood supply through the retinal vein and artery. Blockage of the retinal vein is known as a retinal vein occlusion, while blockage of the retinal artery is known as a retinal artery occlusion or eye stroke.

After the retinal vein is blocked by cholesterol deposits, blood and other fluids spill into the retina, and the area around the retina (macula) becomes swollen. This could affect your central vision, although timely intervention can reverse the condition.

Symptoms of retinal vein occlusion include:

• Pain in the affected eye
• Blurry vision in one eye
• Change of vision in one eye
• Dark lines or spots in your vision

Retinal vein occlusion is common in people aged 50 and above. However, you can get the condition if you are exposed to risk factors that include glaucoma, diabetes, high blood pressure, and hardened arteries.

Hollenhorst Plaque

A Hollenhorst plaque is a rare symptom that presents itself as if a piece of cholesterol or fibrin (a protein) makes its way to your retina. The fibrin usually comes from a larger artery, like the carotid artery. While Hollenhorst plaques are rare, they often indicate something a lot more serious.

The condition is common in older generations and does not necessarily present any symptoms. In many cases, you won’t realize the condition until it causes blockages. A Hollenhorst plaque may indicate a blockage or a larger clot in the carotid artery.

If the condition is not remedied, the clot could move to the brain and lead to a stroke.

Diagnosis Cholesterol in the Eyes

Diagnosing cholesterol in the eyes largely depends on the symptoms and underlying causative factors. For example, xanthelasma can be diagnosed through a visual examination, while a Hollenhorst plaque may be difficult to diagnose until the deposit makes its way to the eye.

Patients with high cholesterol should visit an ophthalmologist or optometrist for further tests and analysis of their eye health. Checking your lipid levels can help in the diagnosis of LDL and subsequent eye complications.

Doctors may also recommend liver function and diabetes tests and advise on a formal cardiovascular assessment.

Treating Cholesterol Conditions in the Eyes

While most of the issues mentioned above can be treated, it’s important to remember they are merely symptoms of a larger underlying problem. The treatment could vary depending on the symptom in question. Your doctors will likely start a medication regime to lower high LDL levels if you exhibit any of the symptoms.

Some of the prescribed medication may include:

• PCSK9 inhibitors like Evolocumab and Alirocumab
• Statins like Fluvastatin, Atorvastatin, and Lovastatin
• Bile acid sequestrants like Colesevelam, Colestipol, and Cholestyramine

Other treatment approaches like cosmetic surgery may also be an option. This is especially true in the case of xanthelasma.

If the fatty deposits are small or few, you can opt for laser therapies. Discuss with your healthcare provider the best remedial options for you.

Preventing Cholesterol in the Eyes Symptoms

While there are available treatment options, they can be rather costly and ineffective if the condition has developed beyond a certain point. The best way to avoid the abovementioned symptoms is by controlling your cholesterol levels.

The best and most effective ways to manage and lower your cholesterol include:

1. Managing Your Weight

Being obese or overweight can increase triglyceride and LDL cholesterol levels in the body. Dyslipidemia patients should especially try to manage their weight as it can significantly reduce triglyceride and LDL cholesterol levels.

2. Eating a Healthy Diet

You are what you eat, and if you consume high cholesterol foods, the fatty deposits will fill your body and blood vessels. Dietitians advocate for a diet rich in fruits, whole grains, vegetables, fiber, healthy fats, and protein.

3. Getting Regular Exercise

There are numerous benefits to physical exercise. Among these is the ability to lower LDL levels and boost HDL cholesterol levels in the body. Take up regular physical exercises like cycling, walking, walking, and running.

4. Reducing Your Intake of Alcohol

Drinking excessive amounts of alcohol can increase triglyceride and bad cholesterol levels. Specialists advise women and men to drink no more than one and two drinks per day, respectively.

5. Quitting Smoking

Smoking tobacco products raise LDL levels and counteract the positive effects of HDL cholesterol. Smoking has also been linked to a wide array of complications and diseases.

FAQs

Can high cholesterol cause bad eyesight?

Yes, an increase in LDL levels can affect your vision and eyes in multiple ways, ranging from benign and cosmetic issues to irreversible and life-threatening complications.

Are eye issues caused by high cholesterol reversible?

Some of the vision complications caused by high cholesterol can be reversed through treatment and surgery. However, other conditions can lead to irreversible effects like glaucoma and permanent vision loss.

Can doctors tell if you have high cholesterol by looking at your eyes?

Your eyes contain blood vessels that can be clearly observed without the need for invasive procedures. Examining your eyes can help physicians determine potential clot and plaque levels in your body.

References

1. Benefits of Physical Activity. (November 2021). Centers for Disease Control and Prevention.

2. Dietary Guidelines on Alcohol Consumption. (August 2020). Dietary Guidelines for Americans.

3. LDL and HDL Cholesterol: Bad and Good Cholesterol. (January 2020). Centers for Disease Control and Prevention.

4. Association of Statin Use and High Serum Cholesterol Levels with Risk of Primary Open-Angle Glaucoma. (May 2019). Journal of the American Medical Association (JAMA Ophthalmology)

5. What is Arcus Senilis? (April 2019). American Academy of Ophthalmology.

6. Cholesterol and Your Eyes and Vision. (June 2018). State University of New York, College of Optometry.

7. Xanthelasma Palpebrarum: More than Meets the Eye. (April 2018). National Center for Biotechnology Information.

8. Stroke and Cholesterol. (August 2017). South Carolina Department of Health and Environmental Control.

9. Dyslipidemia in Obesity: Mechanisms and Potential Targets. (April 2013). National Center for Biotechnology Information.