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Cholesterol is an essential fatty acid that your body needs to function. Cholesterol is used to build cell walls, create hormones like testosterone and estrogen, and synthesize vitamin D.
Despite being important for normal bodily functions, if your cholesterol gets too high, you may experience problems — sometimes in your eyes.
Stroke is the third most common cause of death¹ in the United States and is strongly correlated with high cholesterol. When talking about high cholesterol, we usually worry first about the heart or the brain, not the eyes.
Excess cholesterol can accumulate in and around the eyes. This leads to a range of symptoms, from yellow plaques on the eyelids to rings around your cornea, the colored part of your eye. High levels of cholesterol in your blood, specifically the “bad” LDL cholesterol, can cause the accumulation of plaques, thus blocking the flow of blood to your heart, brain, eyes, or other organs.
This blocking of blood flow can damage your tissues, the severity of which depends on where the blockage is and the degree of blockage.
Below are a few of the more common eye-related symptoms of high cholesterol and how they occur. If you are experiencing any of these symptoms, it is important to talk to your doctor as soon as you can.
Xanthelasma palpebrarum (XP) is a condition commonly associated with excess LDL cholesterol in your bloodstream.
Of those suffering from XP, nearly 50% have some sort of cholesterol problem. Many risk factors for developing XP include inflammation of the pancreas, smoking cigarettes, diabetes (type 1 and type 2), obesity, and cardiovascular diseases. Being of a certain descent, i.e., Mediterranean or Asian, can also leave you more at risk.
The primary symptom of XP is yellow plaque deposits on the exterior of the upper eyelids. Despite being abnormal, the lumpy deposits rarely cause problems with the function of the eyelids.
Xanthelasma does not go away on its own and will stay the same size if your cholesterol levels are corrected — however, left unchecked, they may grow. There are a variety of possible treatments for XP, sometimes involving cosmetic surgery to remove the yellow deposits.
If your cholesterol is still high, you may see the return of these deposits once they have been removed. So it is important to address your cholesterol levels before focusing on removing the deposits.
Arcus senilis (AS), sometimes called a corneal arcus,² is another symptom associated with too much cholesterol in your system.
The cause of this condition is controversial but may be associated with excess lipids leaking into the area around the cornea. Characterized by a white, blue, or gray ring around the cornea, the colored part of your eye, AS is a benign condition found primarily in the elderly.
This ring doesn’t affect your ability to see but acts as a warning sign that your cholesterol is higher than it should be. The ring may start from the top or the bottom of your eye, slowly spreading until it is a complete ring.
The presence of this condition in those younger than 50 years old should prompt an evaluation of the patient’s lipid profile, including triglyceride level.
Retinal vein occlusion³ (RVO) refers to a blood clot that blocks the main vein in your eye, thus preventing the normal flow of blood to your retina, the light-sensitive tissue in the back of your eye.
Lack of blood flow can damage your eye, specifically the nerve cells that receive light and transmit the information to your brain. Partial or complete painless loss of vision is common in cases of RVO, so it is important to seek immediate medical attention. You may also experience pain, blurry vision, or dark spots.
Without treatment, you may experience permanent damage — so you should see your doctor as soon as possible if you suspect you have this condition.
Hollenhorst plaque is the waxy yellow plaque that can build up in your arteries, usually at the point at which it splits into two.
This plaque can block your arteries, creating a stroke event by preventing blood flow to your tissues.
Hollenhorst plaque is a common cause of retinal artery occlusion (RAO), where the plaque has blocked the flow of blood to the artery that supplies your eye with nutrients and oxygen. High cholesterol increases the risk of developing plaques, so maintaining a healthy cholesterol level helps prevent this.
Not all symptoms of high cholesterol are common. If you have high cholesterol and are experiencing problems with your eyes, it’s a good idea to talk to your doctor as soon as possible.
You may be experiencing symptoms of cholesterol-based plaques in or around your eyes. Elevated levels of “bad” LDL cholesterol in your blood can contribute to many medical conditions, including high blood pressure, stroke, and coronary artery disease.
To resolve the problems with your eyes, you must address the real culprit, the LDL cholesterol in your blood. The good news is that you have many tools to help limit the amount of cholesterol entering your body and can even reduce the cholesterol levels in your blood.
Diet and exercise are the two best ways to fight high cholesterol, with medications offering a boost should they be needed. Consuming food low in saturated fats and high in unsaturated fats and fiber will help your body clear out excess cholesterol from your system and limit the amount of new cholesterol your body takes in.
Some conditions, like xanthelasma, may need cosmetic surgery to remove the cholesterol deposits from the eyes.
Even if the deposits don’t cause problems for your eyes, you may find them unsightly and want them removed. Lowering your cholesterol can prevent these deposits from returning.
Other conditions, like arcus senilis, won’t cause you any problems and act more as a warning sign of high cholesterol. Speak with your doctor if you feel you have any of these conditions to learn some long-term monitoring strategies.
Are you experiencing any of these cholesterol-related eye symptoms? It is important to see your doctor if you have any concerns about your eyes or your cholesterol levels. Even gradual changes in your vision can indicate that your cholesterol is too high and starting to cause problems.
It’s easy to test for high cholesterol with a simple blood test called a “lipid profile.” This involves the doctor taking a small sample of blood, preferably following an 8 to 12-hour fast, and sending it to the lab where they test the cholesterol types and amounts. The results give them the information they need to decide the best course of action.
You will normally get your results within a few days, and the doctor will provide you with a plan for getting back on track, which may include cholesterol-lowering medication in some cases.
If you are experiencing any pain or discomfort around the eyes or are experiencing partial or complete blindness, it is important to see your doctor immediately. Even if you aren’t in any pain, your eyes' high cholesterol symptoms shouldn’t be ignored.
Treatment may be as simple as some lifestyle changes, like altering your diet and getting a bit of exercise. By making a few small changes to your lifestyle, you can reduce your cholesterol and prevent these symptoms from recurring.
Discussions about high cholesterol tend to focus on the heart and cardiovascular health, but your eyes can also be affected, sometimes in ways that cause problems.
Symptoms of high cholesterol in the eyes include yellow plaques, white rings around your cornea, and “mini-strokes” where a cholesterol plaque has blocked blood flow to part or all of your eye.
It is a good idea to see your doctor if you are concerned about your cholesterol or have one of these symptoms. They will test your blood for cholesterol and offer you a treatment. High cholesterol can easily be treated, and it’s often as easy as changing your diet and getting more exercise.
Hollenhorst plaque | NIH: National Libarary of Medicine
Arcus senilis | NIH: National Library of Medicine
Central retinal vein occlusion | NIH: National Library of Medicine
Xanthelasma palpebrarum | NIH: National Library of Medicine
Physiology, cholesterol | NIH: National Library of Medicine
Xanthelasma | Eye Wiki
What is xanthelasma? | American Academy of Opthalmology
Biochemistry, LDL cholesterol | NIH: National Library of Medicine