Looking deeply into someone’s eyes can be telling, beyond the eyes themselves.

There’s new promise that in some patients, doctors can see into the future…and see who is going to suffer a stroke, by performing a simple eye exam.

What’s amazing about an eye exam is that you can directly visualize the blood vessels and the nerves. So, you can see when the vessels are damaged--which turn out to portend a stroke that will happen in the future.

According to new research published in the journal Neurology, people with changes in the small blood vessels in their eyes are more likely to suffer a stroke than people who do not have damaged vessels.

Dr. Stephen Marks, Director of the Stroke Treatment Center at Westchester Medical Center, says, “If blood vessels are injured by turbulence and high pressure then they start to change they can develop some hardening of the arteries or atherosclerosis some vessels might get weakening and develop little aneurisms.”

Researchers took special photos of the retina--the back of the eye--and looked for damage to the small blood vessels, a problem called retinopathy. They looked for bleeding spots, and spots where the arteries get so thick they compress the veins--a problem called a-v nicking.

The researchers then followed the more than 3500 participants for seven years, tracking who had strokes or mini-strokes, also known as transient ischemic attacks.

Those with retinopathy--the bleeding spots, or artery changes were much more likely to have a stroke than those without the damage. The risk was even higher for those with more than one of these blood vessel signs.

Overall, the study found people with these types of blood vessel abnormalities were two to three times more likely to suffer a stroke, even in absence of any other risk factors, like diabetes or high blood pressure.

All this makes sense, given stroke is caused by either a burst blood vessel in the brain, or blockage of a vessel.

That’s what happened to Eileen Silverman. “I went to work everyday I worked in the office it just didn’t seem to be to much wrong with me and I continued and continued and then the stroke struck,” says Eileen.

Her daughter Joanne recalls, “She ran a business, she was an accountant.//Our lives changed in seconds her memory was severely impaired.”

There was no warning sign when Eileen’s stroke occurred. But for her daughter Joanne, now there is something she can do to see if she is at risk. “It is a concern for sure. There is a battery of things in the family high cholesterol diabetes, high blood pressure. It is definitely a concern,” says Joanne.

“I certainly think that there is some value for people in their forties to have routine eye exams. The eye exam can say you do have atherosclerotic changes and that puts you at a higher risk for a stroke and you know that could be a wake up call for you to address certain factors,” says Dr. Marks.

The authors aren’t saying everyone who has these changes are at risk for stroke, but it might indicate that a person should look further into other workups and a more aggressive approach at changing one’s lifestyle.

The tiniest of vessels…giving a big warning sign of a huge and looming medical problem.

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