Living Well

When a Simple Eye Exam Reveals a Deadly Diagnosis

As Ellie peered into the mirror, black dots began speckling her vision, and a second mirror image of herself appeared...

But this was no scene from a horror movie. The 21-year-old had just been plucking her eyebrows when she started seeing double and black spots.

Her doctor thought she had an ear infection. But a round of antibiotics didn't fix the strange vision problems.

So Ellie chalked it all up to just needing some glasses and went to the optical store at 11 a.m.

There, a simple eye exam revealed she had papilledema, or swelling of the optic nerve at the back of each eye. And because she had also complained of head and neck aches shortly before experiencing altered vision, she was referred to the hospital.

As it turned out, fluid had built up deep inside Ellie's brain, causing a dangerous amount of pressure in her skull. So 12 hours later, she had emergency surgery to get the fluid drained. An MRI the next day showed she had a benign brain tumor.

Thankfully, the likelihood of developing a malignant brain tumor is uncommon – you have less than a 1% chance in your lifetime.

Some, but not all, brain tumors can be detected through a comprehensive eye exam. (I'm talking about the kind that includes dilating your pupils for a better look at the back of each eye.) Still, a visit like Ellie's – or better yet, an exam with an ophthalmologist (or eye doctor) – may reveal the warning signs that something could be going terribly wrong in your body.

A 2020 survey from the American Optometric Association found that nearly half of Americans skip getting a comprehensive eye exam each year.

But doing so can put your vision – and your whole-body health – at great risk.

It's estimated that 80 million Americans suffer from diseases that come with a terrible side effect: blindness. Here are some examples of some serious health problems and their ocular red flags...

Brain tumor: Changes in the optic nerve and disc due to swelling in the brain, as well as symptoms like double vision, pupil-size changes, and vision loss reported by the patient.

Type 2 diabetes: Abnormal, broken blood vessels, minor bleeding, and small, pale "cotton-wool spots" in the retina could be signs of diabetic retinopathy, which can lead to blindness if untreated.

Cancer: Tumors that have spread from other places in your body, leukemia (from specific types of retinal bleeding), and skin cancer (on the eyelids, for instance).

Stroke: Sudden loss of side vision or developing blind spots, blockages in blood vessels, and bulges in ocular blood vessels called aneurysms.

Hypertension: Broken and oddly bent blood vessels and minor bleeding may be present.

Multiple sclerosis: Inflamed optic nerve due to your glitching immune system, vision loss, and pain when moving the eye.

Rheumatoid arthritis: Dry eye, as well as an inflamed sclera (the whites of your eyes)...

And get this... scientists are exploring the relationship between your eyes and kidneys. A study published in December found that patients with kidney disease had thinning in the back of their eyes (like the retina) compared with their healthy counterparts. The scientists used optical coherence tomography, which is a noninvasive way to capture cross-sectional images with high resolution (versus an MRI, which is blurrier).

And of course, an eye exam will alert your doctor to other major eye problems like...

  • Glaucoma 
  • Cataracts
  • Age-related macular degeneration 

As for when to get checked out, you should schedule an appointment as soon as possible if you have any of these risk factors for eye disease:

  • Having eye disease in your family history
  • Having certain medical conditions like diabetes, migraines, or high blood pressure
  • Taking certain medications with ocular side effects

That goes for any age. But even if you've got crystal-clear vision and have zero risk factors, you should get your eyes screened once you hit 40. That way, you'll establish a baseline for ocular health and catch the sneaky early signs of eye disease.

And, if you noticed, vascular problems and inflammation were the common themes among the "red flags" I mentioned earlier. So, do what I do on top of getting my annual eye checkup...

  • Exercise regularly. If you're just starting to peel yourself off of the couch these days, start small with a gentle, low-impact exercise like walking. I love my post-lunch 15-minute walk just as much as my high-intensity interval training. 
  • Eat dark, leafy greens like kale and spinach – they contain lutein, which is a natural antioxidant that's great for eye function.
  • Eat foods like fatty fish and nuts – they're loaded with anti-inflammatory omega-3 fatty acids.

(Oh, and inflammation is also the real way cholesterol relates to heart disease. I explained that in the May and June issues of Retirement Millionaire. If you're not a subscriber, give my flagship newsletter a trial run right here.)

Finding an eye doctor whom you like working with is also important. Together, you should create an exam schedule that fits your specific needs. If you don't already have one, or if you think it's time to change doctors, ask your friends and family for recommendations

The wrong thing to do is to shrug off the beginnings of changes in your vision and blame it on getting older. Be proactive and schedule an appointment with your eye doctor if you're noticing even a little blurriness or occasional floaters. You might not have a brain tumor, but getting checked out will give you peace of mind and improve your quality of life.

What We're Reading...

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
July 23, 2024