National Cholesterol Education Month

September is National Cholesterol Education Month, which leads up to World Heart Day on September 29^th. The purpose of this observance is to increase awareness and knowledge of cholesterol, cardiovascular disease, and stroke – all of which can be quietly occurring without any symptoms until it is too late. Cardiovascular disease can cause a sudden heart attack in an otherwise seemingly “healthy” person.

Hypercholesterolemia is a type of lipid disorder, which means there is too much cholesterol (or fat) in the blood stream. It can be genetically inherited or develop secondarily to lifestyle choices and/or other medical conditions. Obesity, smoking, hypertension, and diabetes can contribute to the diagnosis of high cholesterol.

While too much cholesterol is detrimental, the body still requires some cholesterol to function properly. A cholesterol screening can be accomplished with routine blood work. Total cholesterol is composed of HDL (high-density lipoprotein or “good” cholesterol), LDL (low-density lipoprotein or “bad” cholesterol), and triglycerides. Based on the results, the primary care physician will determine if treatment is necessary. Maintaining a balanced diet and regular exercise is always the first step in staying heart healthy.

The retinal blood vessels are the only blood vessels in the body that can be directly visualized without elaborate scans or surgery. Therefore, the appearance of the blood vessels inside the eyes can indicate what the blood vessels look like throughout the rest of the body. Uncontrolled hypertension, high cholesterol, and diabetes all have negative impacts on these tiny blood vessels.

Ocular Conditions Associated with High Cholesterol:

Xanthelasma
Xanthelasma (zan-thuh-lahz-muh) is a pocket of fat located just underneath the skin. It appears as a mildly raised yellow lesion around the inner part of the eyelids towards the nose. Xanthelasma is most commonly seen in someone with high cholesterol. While the lesions do not cause any problems of their own, they can be cosmetically unpleasing for some individuals.

Arcus
Arcus is a light gray or blueish ring around the iris. It is more apparent in someone with dark brown eyes. If arcus is present in a person under the age of 45 years old, it can be a sign of high cholesterol, and warrants bloodwork. On the other hand, arcus senilis is a more common form of arcus in people over 60 years old that does not necessarily indicate high cholesterol.

Eye Stroke
A Hollenhorst plaque is a piece of cholesterol buildup that blocks a small artery in the retina. When the tissue that is supplied by this artery does not receive enough oxygen and nutrients, the retinal tissue dies and a retinal artery occlusion occurs. This event is analogous to a stroke in the brain, which is also impending based on the findings.

In order to minimize the risk of these conditions from occurring, it is best to have routine appointments with a primary care physician to complete the necessary bloodwork for monitoring cholesterol levels.