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Are the eyes a window to the heart as well as the soul? New insights and older observations suggest the answer is yes. Changes both around and inside your eyes, some visible only with special tests, may be harbingers of heart disease.

Sudden vision changes such as blurriness, dark areas, or shadows could be a blockage in an eye blood vessel, which can foreshadow a more serious stroke in the brain. And growing evidence hints that subtle, early damage to tiny blood vessels in the eyes may predict cardiovascular disease. Other unusual eye changes also can be clues to possible heart problems, such as small, yellowish bumps around the eyes, or pupils that widen and constrict with the heartbeat.

Yellow bumps around the eyes: Xanthelasmas

Some middle-aged and older adults develop soft, yellowish, cholesterol-filled bumps on or around their eyelids, most commonly near the nose. Called xanthelasmas, these small growths aren’t painful and rarely affect vision. But they can be a sign of high levels of cholesterol, triglycerides, or other fats (lipids) in the blood. They’re somewhat more prevalent in women than men. People who have them should be sure to get a cholesterol test, also known as lipid test or lipid profile.

Xanthelasmas are more common in people with genetic disorders that cause abnormally high cholesterol levels, such as familial hypercholesterolemia, which can cause LDL cholesterol levels of 190 or higher. (A healthier LDL is under 100.)

If your LDL is elevated, regular exercise and a high-fiber, plant-based diet can help lower it. Many people need cholesterol-lowering drugs such as statins, which will sometimes but not always reduce the size of a xanthelasma.

Half of people with xanthelasmas have normal lipid levels, and the growths are simply a cosmetic problem. But people with a family history of early heart disease should make sure their physician knows about this possible sign of heightened cardiovascular risk.