Why a routine eye checkup can be an act of foresight

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Now, a growing body of research suggests that vision health is far more than a matter of eyesight. It’s an early warning system for chronic illness, a marker of neurological function, and a casualty of modern life. According to the International Agency for the Prevention of Blindness (IAPB), global vision impairment is projected to rise by 55% over the next three decades. With digital eye strain affecting younger demographics at unprecedented levels, eye health is fast becoming one of the most urgent— and under recognized—frontiers in preventive medicine. 

RISING TOLL OF MYOPIA AND DRY EYES

Never before in human history have so many people spent so many hours staring at screens. Children now attend digital classrooms; adults toggle between devices for work and leisure. The question looms: What is this doing to our eyes? 

“Studies show that prolonged screen time, especially up close, can contribute to a rise in myopia (nearsightedness), particularly in children. While some argue that digital eye strain is overblown, the reality is that screens can cause strain, dryness in eyes, and discomfort in the short term and conditions like myopia in the long term," says Dr Ajay Sharma, founder and chief medical director of Eye-Q Eye Hospitals, Gurugram. 

According to Time Trends on the Prevalence of Myopia in India – A Prediction Model for 2050, published in April 2021, the incidence of myopia among urban children aged 5 to 15 has seen a dramatic rise—from 4.44 percent in 1999 to 21.15 percent in 2019. At the current rate of increase—approximately 0.8 percentage points per year—the prevalence is projected to reach 31.89 percent by 2030, 40.01 percent by 2040, and a staggering 48.14 percent by 2050. A recent report in the Indian Journal of Clinical and Experimental Ophthalmology (Jan–Mar 2025) found that over 80% of ophthalmologists see Dry Eye Disease (DED) in up to 60% of their daily OPD patients. Nearly 89% cited prolonged screen exposure as a key environmental trigger. 

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But screen exposure alone doesn’t explain the surge in DED, particularly post-pandemic. “There are multiple factors contributing to an increase in DED," says Dr Purnendra Bhasin, founder and director of Ratan Jyoti Netralaya, Gwalior. “Aside from reduced blink rates during screen time, we’re seeing the impact of indoor pollutants, air-conditioning systems, hormonal changes—especially in postmenopausal women—and even poor nutrition. Deficiencies in vitamin A, D, and omega-3s play a direct role in tear film instability and meibomian gland dysfunction." 

A WINDOW TO THE BODY

Sharma notes, “Mainstream medicine has been a bit slow in fully integrating eye health into preventive care because, traditionally, eye exams have focused mainly on vision issues, not overall health. The eye’s potential to reveal early signs of Alzheimer’s or cardiovascular disease has only recently gained attention. Another reason is that ophthalmology has often been treated as a separate specialty, so it’s not always part of routine checkups."

Another emerging player in ocular health? The gut. “Your gut might be talking to your eyes," says Max Kushnir, co-founder and chief scientific officer at Sova Health. “The gut microbiome—a dense network of microbes in your digestive tract—does more than aid digestion. It regulates immunity, produces essential nutrients, and protects the gut wall. When that system is out of balance, the eyes can feel the fallout." Gut dysbiosis has been increasingly linked to ocular diseases. 

“In age-related macular degeneration, it may heighten inflammation and oxidative stress, damaging retinal cells. In diabetic retinopathy, it can worsen insulin resistance; in glaucoma, chronic systemic inflammation may accelerate optic nerve damage. Disruption of the gut barrier can also allow toxins into the bloodstream, breaching the blood-retinal barrier and fueling degeneration," Kushnir adds. 

It’s often said that the way to the heart is through the eyes. Medically, that holds more truth than poetry. The retina offers a rare, non-invasive window into the body’s smallest blood vessels—capillaries— making it a powerful tool for assessing cardiovascular health. 

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Dr Dixit Garg, consultant interventional cardiologist at Manipal Hospital, Gurugram, explains: “A retinal scan can reveal early signs of hypertension and diabetes, two leading risk factors for heart disease. Subtle changes in the retinal vessels— such as narrowing arteries or signs of diabetic retinopathy—can reflect broader issues in the cardiovascular system. This makes retinal examinations valuable not just for diagnosis, but for ongoing monitoring." Despite this, collaboration between cardiologists and ophthalmologists remains limited. Garg says, “Our specialties often function in silos, even though early detection through retinal screening could prompt timely interventions. In some hospitals, a lack of an in-house ophthalmology department f urther delays this integrated care."  

THE EYE CARE ACCESS GAP

India performs about 6.5–7 million cataract surgeries annually. But elective procedures like LASIK (a laser refractive surgery to correct vision problems) number in the hundreds of thousands. “We’re seeing a transition from reactive to proactive eye care," says Bhasin. “With rising rates of diabetes, retinal surgeries are also increasing. Advances in imaging and surgical techniques are transforming care—but access and awareness still vary drastically."

Tools like Spectral-Domain OCT, OCT Angiography, and ultra-widefield imaging allow detection of vascular changes before symptoms appear. Yet, Bhasin emphasizes, “Screening and patient education remain weak links. Technology is there—but awareness and implementation are the rate-limiting steps." 

Mild visual disturbances—like occasional blurring, flashes of light, floaters, or slight distortions—are often brushed off by patients and overlooked in routine checkups. Attributed to fatigue or minor refractive shifts, these early signs can, in fact, signal the onset of serious eye conditions like retinal tears, macular edema or optic neuropathies. Bhasin says, “Equally underestimated are symptoms like persistent eye redness or a gritty sensation— often early indicators of chronic blepharoconjunctivitis or ocular surface disease. In diseases like glaucoma, where vision loss creeps in silently, missing these clinical cues can mean the difference between preserving sight and permanent impairment." 

These early warnings are not to be ignored as non-issues but treated as red flags warranting prompt evaluation. Routine eye exams—with dilated retinal assessment and intraocular pressure checks—remain essential tools in catching problems before it’s too late. “Vision care often gets overlooked in global public health because urgent issues like infectious diseases and malnutrition usually take precedence," Sharma says adding, “We need policies that support wider access: subsidies, telemedicine, and integrating eye exams into primary care." 

Tanisha Saxena is a Delhi-based independent journalist. She writes stories that are on the intersection of art, culture and lifestyle.

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