Retinal Disease from High Blood Pressure

Vein Occlusions and More

Many adults have high blood pressure and by the age of 55, more than half of all adults have high blood pressure. Less than half of Americans have their blood pressure under control. The consequences of uncontrolled blood pressure are many throughout the body, and can include damage to almost any organ, including the brain, heart, kidneys, and eyes. An extremely high blood pressure can result in serious damage in a relatively short period of time, even hours. It is important to understand, however, that even a moderately high blood pressure over time can result in serious organ damage as well.


The retina is perfused by a very fine microvasculature, that is microscopic arteries and veins, which are particulary susceptible to damage from high blood pressure. In many instances, a retinal specialist can note vascular changes consistent with chronic high blood pressure. Prevention of hypertensive disease by early diagnosis and treatment of high blood pressure is essential in avoiding unnecessary disease later in life.


Some of the retinal diseases that result from hypertension include vein occlusions and optic nerve damage. Retinal vein occlusions are primarily the result of uncontrolled high blood pressure, although they can result from numerous less common systemic (full body) disorders also. In the simplest of terms, a retinal vein occlusion is a “stroke” in the retina. Patients should understand this point because it is frequently the first vascular event a patient has suffered, and as such can serve as a warning sign to the patient and doctor of possible future heart disease or stroke. When viewed in this way, retinal vein occlusions should stimulate the patient to seriously assess risk factors for vascular disease and institute measures to reduce this risk. Most often the first measure should be to seek evaluation from the primary care doctor to control the blood pressure immediately with medications. This alone can save life and prevent much future disease.

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High Blood Pressure and Eye Disease

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Along with causing heart and kidney problems, untreated high blood pressure can also affect your eyesight and lead to eye disease. Hypertension can cause damage to the blood vessels in the retina, the area at the back of the eyewhere images focus. This eyedisease is known as hypertensive retinopathy. The damage can be serious if hypertension is not treated.

What Are the Symptoms of Hypertensive Retinopathy?

A person typically won't experience symptoms of mild to moderate hypertensive retinopathy; it is usually discovered during a routine eye exam. Symptoms of more severe and accelerated hypertension might include headaches and vision problems.

Severe retinopathy can occur alongside high blood pressure during pregnancy, so prenatal care is important. 

How Is Hypertensive Retinopathy Diagnosed?

An eye care professional can diagnose hypertensive retinopathy. Using an ophthalmoscope, an instrument that projects light to examine the back of the eyeball, the doctor will look for signs of retinopathy that include:


  • Narrowing of blood vessels
  • Spots on the retina known as cotton wool spots and exudates
  • Swelling of the macula (the central area of the retina) and optic nerve
  • Bleeding in the back of the eye

How Is Hypertensive Retinopathy Treated?

The best way to treat hypertensive retinopathy is to adequately control your blood pressure.

Can Hypertensive Retinopathy Be Prevented?

To prevent hypertensive retinopathy, keep your blood pressure under control by reaching and maintaining your optimal weight, sticking with a diet recommended by your physician, exercising regularly, and faithfully taking your high blood pressure medications as prescribed. In addition, see your doctor on a regular basis for follow-up care.

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WebMD Medical Reference Reviewed by Alan Kozarsky, MD on July 02, 2018

Sources

SOURCE: American Heart Association. 

© 2018 WebMD, LLC. All rights reserved. 

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