Our eyes are the windows to our soul. They may also be the windows to our heart.
Researchers believe routine eye exams may soon be able to detect and predict systemic disease, including the risk of a heart attack and the presence of atrial fibrillation (an irregular, fast heartbeat).
This exam would provide a non-invasive alternative to other tests, make screening easier for those in rural areas and allow people to take action before they experience harm.
“As a cardiologist, I see too many people whose first sign of heart disease is a heart attack,” says Dr Girish Dwivedi, a professor of cardiology at The University of Western Australia (UWA).
“We want to catch heart disease early, while there is still time to act. The eye gives us that chance. It is the only place in the body where you can look straight at living blood vessels, without a needle, an X-ray or surgery.”
What our eyes reveal
Our eyes are not only revealing, says cardiologist Professor Hosen Kiat, they are an often overlooked organ in medicine.
There are associations between cataracts, glaucoma and an increased risk of heart disease; a blue or grey ring around the cornea can indicate high cholesterol; and rarely, high cholesterol can also cause yellow bumps, called xanthelasma, around the eyelids.
What is most revealing, however, is the blood vessels behind our eyes.
“The tiny vessels at the back of the eye and the vessels of the heart grow from the same tissue early in life,” Dwivedi explains. “They are also affected by the same things, such as atherosclerosis, diabetes and hypertension. When the vessels in your eye are under strain, it is often a clue that your heart is too.”
By giving a patient eye drops to dilate the pupil, ophthalmologist Dr Tanya Trinh can take a photo and then analyse it for narrowing, leaking blood or cholesterol and haemorrhages.
“Sometimes what we can see is little cholesterol plaques that have actually blocked off a blood vessel, and you can have a little stroke in the eye,” she says.
And because these are the only blood vessels that can be viewed directly, health issues can be detected earlier, says Kiat: “There are no blood vessels that we see so clearly like the retinal arteries in an eye exam, even with coronary angiography, for example, we just see the dye, we just see the contrast.”
How effective is the eye at revealing the health of our heart?
A 2025 study found an eye scan could predict the likelihood of a person having a heart attack or stroke in the next decade with 70 per cent accuracy. Meanwhile, a study published in September found people with a thinning of their retinal layers had a 27 per cent higher risk of atrial fibrillation.
And on Wednesday, the Heart Foundation awarded the Vanguard Grant, its most prestigious funding grant for research, to biomedical engineer and researcher Dr Hadi Afsharan, who works alongside Dwivedi at UWA.
They have developed a special scan using polarisation, in addition to the standard light used in an eye scan, to detect changes in the walls of the vessels including thickening and structural breakdown.
This allows them to detect coronary artery disease (CAD), Australia’s leading cause of death, with 80 per cent accuracy.
The scan takes about four seconds, it doesn’t require eye drops, and analysis is done in less than 30 seconds. It is a non-invasive alternative that can potentially
improve risk screening for heart disease and be an affordable alternative to calcium scoring, which is non-invasive but exposes the patient to radiation and doesn’t detect soft plaques.
“Soft plaques are the most important factor in heart attacks,” Afsharan says.
“Our early results are very encouraging. People with heart disease have clearly different scores from those without it, and the scores rise as the disease gets worse,” adds Dwivedi. “We turn them into one simple score, a bit like body mass index, but for your blood vessels.”
If eye scans are effective, why aren’t we using them already?
The field of oculomics – the use of non-invasive eye imaging and artificial intelligence as a health-screening tool – is about a decade old, says Professor Jason Kovacic, the chief executive of the Victor Chang Cardiac Research Institute.
“While the progress is exciting, it hasn’t yet undergone any major clinical trials – that I am aware of – to prove efficacy in terms of changing management or reducing rates of heart attack or stroke or death,” Kovacic says.
Another issue is that findings are still dependent on expert interpretation of the scan.
“Someone like Tanya [Trinh] probably can pick up subtle signs in retinal vessels better than [someone else] across the road,” says Kiat, who is a co-founder of wellbeing platform TAIK Health.
“With AI it will be easy to integrate all this data so that it is the press of a button and the rest is done by a database based on thousands and thousands and thousands of retinal vessels.”
Training the AI model on more patients is one of the next steps.
“We are teaching a computer to do that work automatically,” Dwivedi says. “That means an optometrist or a GP could do the scan and get a clear result straight away, without waiting for a specialist to review the images.”
That matters most for those in remote communities, who often live far from hospitals that offer heart scans.
They will also compare the eye scan with standard heart tests and give the equipment to other hospitals and research groups to test it independently.
“After that, we plan to trial a portable version in local optometrists and GP clinics,” Dwivedi says. “Like any new medical test, it will also need regulatory approval before it can be used routinely.”
It’s a process that may take up to five years.
“If all goes well, a quick eye scan during a routine check-up could tell us who needs a closer look at their heart,” he says. “That would mean finding heart disease earlier, and sparing many people tests they do not need.”
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Sarah Berry is a lifestyle and health writer at The Sydney Morning Herald and The Age.Connect via X or email.
