High Cholesterol and the Eyes: Signs and Symptoms

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Your body needs some cholesterol, a type of fat, to function properly. However, having too much cholesterol in your blood can negatively affect your health.

Your doctor can test your blood to find out what your cholesterol levels are, but you might also have signs or symptoms—some of which may affect your eyes.

Here is what you should know about the signs and symptoms of high cholesterol that might show up in and around your eyes, and when you should see a doctor for them.

Image of arcus senilis in a brown eye

ARZTSAMUI / Getty Images

Frequent Symptoms

Some common symptoms of high cholesterol can change how your eyes or the area around your eyes looks. It might also affect your vision.

Xanthelasma

The most common eye symptom that is linked to high cholesterol is a xanthelasma—a flat or somewhat raised yellowish area around the eyes or near the nose. The deposits are caused by a buildup of cholesterol under the skin. Xanthelasmas do not affect your vision.

About half of the people who have xanthelasmas have high cholesterol. They are common in females of Asian or Mediterranean descent.

Xanthelasmas are more common if you:

Arcus Senilis

A condition called arcus senilis can also indicate high cholesterol. With this condition, a blue, white, or light gray ring forms around the outside of the front of your eye as more cholesterol reaches the cornea.

The ring will appear around the colored part of the eye (iris). You may think that your iris has two colors, but it’s only a discoloration. The ring does not affect your ability to see.

At first, arcus senilis may only show up at the top and bottom of your cornea. Eventually, it can form a full ring around the cornea.

Not every person with arcus senilis has high cholesterol. However, if your family has a history of high cholesterol, you’re more likely to develop arcus senilis.

Arcus senilis is more common in middle age. As they get older, many adults will eventually develop arcus senilis. You’re also more likely to get arcus senilis if you are a man or Black.

A colored ring around the cornea in children or young adults is called arcus juveniles. When the ring appears around the eyes of children or younger adults, it is a stronger sign of high cholesterol than arcus senilis is in adults.

Retinal Vein Occlusion

The retina is a light-sensitive tissue in the back of your eye. The retina receives its blood supply through the retinal artery and retinal vein. When the vein becomes blocked, it’s called a retinal vein occlusion. If the artery becomes blocked, it’s called a retinal artery occlusion—also known as a stroke.

When the vein is blocked, blood and fluid spill out into the retina. When this happens, the area of the retina called the macula may become swollen. The swelling affects your central vision.

An eye stroke can lead to the death of nerve cells in the eye which, in turn, can cause or worsen vision loss. You may regain your vision within a year after retinal vein occlusion, but your vision may not be the same. To prevent another blockage, you’ll need to keep your cholesterol, blood sugar, and blood pressure levels under control.

The symptoms of retinal vein occlusion include:

  • Blurry vision in one eye
  • Change in vision in one eye
  • Dark spots or lines in your vision (floaters)
  • Pain in the affected eye

Retinal vein occlusion is more common in people age 50 or over. It’s also more common in people who have high blood pressure, diabetes, glaucoma, and hardening of the arteries.

High cholesterol is also common in people with retinal vein occlusion. A 2008 study found that high cholesterol was twice as common in people with central retinal vein occlusion compared to people who did not have the eye condition.

Rare Symptoms

Some symptoms of high cholesterol that affect your eyes or vision are possible, but not very common.

Hollenhorst Plaque

A Hollenhorst plaque is present when a piece of cholesterol, or fibrin, is found in the artery in your retina. This piece of cholesterol usually comes from a larger artery in the body, such as the carotid artery, and can be a sign of more serious issues.

This plaque is more common in older adults. The plaque itself does not cause symptoms; you might not know you have one until it causes a blockage.

A Hollenhorst plaque may indicate a larger clot or blockage in the carotid artery. If that clot or blockage dislodges and moves to the brain, it can lead to a stroke, which can affect your vision, motor control, or sensory control. Strokes can also be fatal.

When to See a Doctor

If you notice a gradual change in your vision, it’s important to tell your eye doctor. An eye exam can help them pinpoint what is causing your eyesight to change.

Some of the eye conditions that are related to high cholesterol, including xanthelasma and arcus senilis, do not typically cause vision changes.

If you experience a sudden loss in vision or you are seeing floaters for the first time, make an urgent appointment with your eye doctor. If your eye doctor is not available, go to the emergency room.

A Word From Verywell

Certain changes to the appearance of your eyes or your vision can be a sign that you have high cholesterol. The conditions that can change how your eyes look—such as arcus senilis—do not affect your vision. Other more serious conditions, like an eye stroke, can lead to vision loss.

If you notice changes in your eyes that are gradual, make an appointment with your eye doctor to get checked out. You should also let your regular doctor know, as they can check your cholesterol levels with a simple blood test.

If you have sudden vision loss or start seeing spots in your vision for the first time (floaters), call your eye doctor right away. If they are not available, go to the emergency room for treatment.

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Article Sources
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  1. American Academy of Ophthalmology. What is xanthelasma? Updated May 12, 2021.

  2. State University of New York College of Optometry. Cholesterol and your eyes and vision. Updated July 23, 2020.

  3. American Academy of Ophthalmology. What is arcus senilis? Updated April 26, 2019.

  4. American Academy of Ophthalmology. What is central retinal vein occlusion (CRVO)? Updated September 8, 2020.

  5. MedlinePlus. Retinal vein occlusion. Updated February 25, 2020.

  6. American Academy of Ophthalmolog. High blood pressure, high cholesterol may be linked to retinal vein occlusion. Updated June 2, 2008.