Abnormal bleeding: Part 1 – How a visit to your optician could help spot leukaemia

In this article, we take a look at how a trip to the opticians could catch a leukaemia diagnosis early.

Increased tendency to bleed (including bruising) is the fourth most common symptom of leukaemia prior to a diagnosis. As well as bruising on the skin without any obvious cause, abnormal bleeding from other areas of the body is also a common symptom of leukaemia. This may include: periods that are heavier or last for longer than usual, frequent nose bleeds, bleeding gums, or cuts that won’t stop bleeding.

“My period was a lot heavier and longer than usual. It continued for 10-12 days but I just put it down to stress.”

However, sometimes the bleeding caused by leukaemia isn’t immediately visible, making it very difficult to spot by yourself. For example, small bleeds behind the eyes (known as “Roth spots”), which can be an indicative sign of leukaemia, can’t be detected without a proper eye examination by an optometrist.

Here at Leukaemia Care, we work closely alongside GPs to ensure they are aware of the signs and symptoms of blood cancers and use appropriate tests to spot leukaemia at an early stage. However, other primary care providers such as opticians or dentists can also be influential in detecting leukaemia earlier. In this blog, we will be focusing on how a routine trip to the opticians could help to spot leukaemia.

“During night shifts I noticed something strange when writing my reports. The letters were appearing like grains of sand and they were falling off the screen.”

“I went along to the opticians, and they did a series of tests and at that point, they expressed concern about retinal bleeding.”  

How can opticians detect leukaemia-related bleeding?

When you visit your local optician for an eye test, you will have your eyes examined by an ophthalmic practitioner or optometrist who, before checking the quality of your vision, will check your eye health. Bleeding in the retina can be detected in a retinal photograph, which many opticians now offer for free as part of a routine eye test. Because this technology is relatively new, the cost of the procedure isn’t currently covered in a free NHS eye test in England, but you will be asked if you wish to pay a small extra fee to receive this.

“I woke one morning with what appeared to be a small patch of blood in my eye. I then made what turned out to be the wisest decision of my life. I went straight to an optician to be examined. She advised me to get a blood check and the result went straight to my GP – I was dangerously anaemic… By the end of the week, the diagnosis was confirmed – I had a rare blood cancer called hairy cell leukaemia (HCL).”

What is Retinal Imaging?

Retinal Imaging (or Retinal Photography) is a new technology currently now used in eye care which enables your optometrist to quickly take a digital picture of the retina (back of the eye where the light hits) along with all the blood vessels within the eye. It is just like taking a normal picture with flash photography.

The image can be immediately viewed and inspected on a computer by the optometrist and, because the picture is such high quality, very subtle changes to the blood vessels at the back of your eyes can be detected straight away.

“I had an eye test whilst I was visiting my mother in Scarborough, and the optician told me that my retinas were haemorrhaging and that I should go straight to hospital (they suspected diabetes).”

In the case of leukaemia, “Roth spots” might be detected in these retinal images. These are described as small, white-centred spots caused by haemorrhaging of the tiny blood vessels at the back of the eye. Generally, Roth spots more likely indicate conditions such as diabetes, anaemia or endocarditis (infection of inner lining of the heart).

“I went to the hospital and as soon as the doctor had a look at the scans of my eyes, he expressed real concern. He found what were called “Roth spots” on my eyes which can be indicative of a more serious cardiac problem. At the time, that was what he thought it was.”

How regularly should I be having an eye exam?

The NHS recommends that we visit our opticians at least once every 2 years. Eye tests are not only done to assess your vision, they are also an essential part of monitoring our health. Other than leukaemia, eye tests can help with the early diagnosis of diabetes, high blood pressure or even tumours in the brain. Despite this, over half of people between the ages of 40 and 75 haven’t recently been for an eye check. This statistic is particularly worrying as it is between this age that you are most likely to develop a form of blood cancer.

If you ever notice any unusual disturbances with your vision, such as black spots, bright flashes of light, blurring of letters when reading, or if any strange physical spots suddenly appear on the whites of your eyes, don’t hesitate to make an appointment with your optician, as it could be more serious than you think.

“Spot Leukaemia is so important. I found a ‘spot’ in my eye and acted upon it. That is the vital thing – don’t wait to see if it will go away.”

Have you been bruising a lot recently? Click here to find out how to spot the difference between bruising in leukaemia and ordinary bruising.


For information on the other symptoms of leukaemia, click here.


For advice on vaccines and blood cancer in general, read our helpful article on why blood cancer patients need vaccinations.

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