Hypertensive Retinopathy

Thursday, Feb 1, 2024 by Nisha Gupta, MD

This month we will talk about hypertensive retinopathy which is caused from chronic high blood pressure.

What is hypertensive retinopathy?

Hypertensive retinopathy is an eye condition where long term high blood pressure (hypertension) damages the retina’s blood vessels. Blood pressure can be high due to several factors such as high cholesterol, obesity, and smoking or caused by other conditions such as hyperthyroidism and sleep apnea. Over time, this pressure damages the blood vessels and blocks blood flow to various parts of the body including the retina. The lack of blood flow causes changes in the retina that can lead to vision loss and other complications.

What are the symptoms?

Many patients do not have any symptoms, especially with early findings of hypertensive retinopathy. If the blood pressure is very high, one may experience headaches, blurry vision, or eye pain. Vision loss can occur when severe high blood pressure causes damage to the optic nerve.

How is it detected?

A comprehensive exam including checking the vision and dilating the eyes to view the retina are imperative. Raised pressure in the vessels tightens them and makes them narrow. This can cause bleeding in the retina and focal areas of ischemia, which are areas that do not receive enough blood flow. The retina and optic nerve may also become swollen.

What are the treatments?

Treatment is geared towards lowering the blood pressure and maintaining it at a normal level. It is important to keep a healthy lifestyle by eating well, exercising, and not smoking. Secondary causes of high blood pressure may require additional treatment. Controlling the blood pressure can also lower the risk of other conditions such as diabetic retinopathy, glaucoma, and blockages of major blood vessels in the retina.

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