Can cholesterol affect vision? 

High cholesterol does not usually cause a direct change in your vision like blurriness or near-sightedness, but it can manifest in and around the eyes in several distinct ways. Certain cholesterol-related conditions can indicate a high risk of cardiovascular disease, while more serious complications, such as a retinal artery occlusion, can lead to sudden and permanent sight loss. In the UK, optometrists and GPs often use the eyes as a window to detect silent lipid disorders. 

In the UK, eye health and heart health are closely linked. Because the blood vessels in the eye are so small and delicate, they are often the first place where the effects of high cholesterol and narrowed arteries become visible to a clinician. While you may feel your vision is perfect, an optometrist might see signs that your ‘bad’ (LDL) cholesterol is too high. This guide explores the different ways cholesterol can affect your eyes and what those signs mean for your overall health. 

What We will cover in this Article 

• The clinical relationship between blood lipids and ocular health. 

• Identifying Corneal Arcus: The grey/white ring around the iris. 

• Xanthelasma: Yellow deposits on the eyelids and their link to heart risk. 

• Hollenhorst Plaques: When cholesterol travels to the blood vessels of the eye. 

• The risk of Retinal Vein and Artery Occlusions (‘Eye Strokes’). 

• How routine eye tests in the UK can help detect high cholesterol early. 

Visual markers of high cholesterol 

There are several physical signs on or around the eyes that are triggered by excess lipids in the bloodstream. These markers do not always impair vision, but they are important diagnostic clues for your doctor. 

Corneal Arcus 

Corneal arcus is a white, grey, or blueish ring that forms around the outer edge of the cornea (the clear front part of the eye). It is caused by the deposition of cholesterol in the corneal tissue. While it is very common in older adults and often considered a normal part of ageing (arcus senilis), its appearance in anyone under the age of 45 is a strong indicator of a cholesterol disorder. 

Xanthelasma 

These are yellowish, flat, or slightly raised plaques that appear on the skin of the upper or lower eyelids. They are essentially deposits of cholesterol trapped under the skin. While xanthelasma doesn’t affect the eye itself or your vision, about 50% of people who have them also have a high level of LDL cholesterol. 

Cholesterol and the blood vessels of the eye 

The most serious way cholesterol affects the eyes is by interfering with the blood supply to the retina. The retina is the light-sensitive layer at the back of the eye that allows you to see. 

Hollenhorst Plaques 

During an eye examination, an optometrist may see a tiny, shiny yellow speck inside a small artery in the retina. This is called a Hollenhorst plaque. It is actually a piece of cholesterol or plaque that has broken off from a larger artery (often the carotid artery in the neck) and travelled to the eye. While the plaque itself may not block vision, it is a significant warning sign of a high risk of stroke. 

Retinal Artery Occlusion (Eye Stroke) 

A retinal artery occlusion occurs when a piece of cholesterol or a blood clot completely blocks the main artery supplying the retina. This is essentially a ‘stroke in the eye’. It causes a sudden, painless loss of vision in one eye. This is a medical emergency that requires immediate attention in an A&E or eye casualty department to try and restore blood flow. 

Condition	Physical Sign	Impact on Vision
Corneal Arcus	Grey/white ring around the iris.	Usually none.
Xanthelasma	Yellow bumps on eyelids.	None.
Hollenhorst Plaque	Shiny yellow speck in retinal artery.	None (but indicates stroke risk).
Retinal Occlusion	No visible external sign.	Sudden, painless loss of sight.

The link between lipids and glaucoma 

Recent research has explored a potential link between high cholesterol and an increased risk of open-angle glaucoma. High cholesterol may contribute to increased pressure within the eye or affect the blood flow to the optic nerve. While high cholesterol is not the primary cause of glaucoma, managing your lipid levels is considered a supportive part of protecting your long-term ocular health. 

Differentiation: Age-related changes vs. Cholesterol 

It is important to differentiate between changes that are simply due to getting older and those that indicate a serious cholesterol disorder. For example, a corneal arcus in a 75-year-old is usually not a cause for alarm. However, if that same ring appears in a 30-year-old, it suggests a genetic condition like Familial Hypercholesterolaemia (FH). If you notice any new rings, bumps, or sudden changes in your sight, an eye test is the first step in determining the cause. 

To Summarise 

Cholesterol can affect the eyes in various ways, ranging from harmless visible rings and bumps to life-threatening ‘eye strokes’. While many signs like corneal arcus or xanthelasma do not directly change your vision, they are vital indicators that your internal lipid levels may be too high. In the UK, optometrists play a key role in identifying these markers and referring patients back to their GPs for a full lipid profile and cardiovascular risk assessment. 

If you experience severe, sudden, or worsening symptoms, such as a sudden loss of vision in one or both eyes, or sudden facial drooping or speech difficulty, call 999 immediately. 

You may find our free BMI Calculator helpful for monitoring weight-related health factors that can influence both your cholesterol levels and your long-term eye health. 

Authority Snapshot (E-E-A-T Block) 

This article was reviewed by Dr. Rebecca Fernandez to ensure clinical accuracy and safety. Dr. Fernandez is a UK-trained physician with an MBBS and extensive experience in cardiology, internal medicine, and emergency medicine. This guide provides evidence-based information on the ocular manifestations of cholesterol to support early detection and proactive cardiovascular care.