At our office, a photo of the back of your eyes is often taken as a part of the eye exam. This provides our optometrist with a snapshot of the blood vessels and nerve layer. The photograph is a great way to document the findings at the back of the eye and serves as a useful reference for changes when returning for annual or biennial eye exams. One condition that our optometrist may be able to see signs of at the back of your eyes is hypertension.
What is Hypertensive Retinopathy?
Hypertension, or high blood pressure, refers to blood pressure that is above 120/80. Hypertensive retinopathy is when hypertension causes adverse effects in the retina, the layer of neuron cells and fibers at the back of the eye. Other adverse effects include optic neuropathy and choroidopathy. The long term effects of uncontrolled hypertension are due to arteriosclerosis, meaning thinning and blockage of the blood vessels that allow for transport of oxygen to various tissues. This can cause vascular occlusion or small aneurysms (bulgings in the blood vessels) and the lack of oxygen transport can lead to vision loss. If caught early, this can be addressed and the blood pressure can be controlled, reversing the more extreme changes that have happened in the back of the eye. However, some signs (i.e. the orientation of the blood vessels) may remain the same, though this is not concerning if it is stable. In extreme cases, the optic nerve can also become swollen. Symptoms of hypertensive retinopathy include eye pain, headaches, and blurry vision.
Hypertension: Causes and Risk Factors
Hypertension can be caused by another disease process or occur on its own. Risk factors include family history of hypertension, diets high in salt, obesity, smoking, excess alcohol consumption, stress, and ethnic background. The biggest risk factor for hypertensive retinopathy is the duration of the elevated blood pressure. The longer the blood pressure has been elevated, the more severe the damage to the back of the eye will be.
High Blood Pressure Treatment
The treatment for this condition is mainly focused around controlling the blood pressure and bringing it to a normal level. It is important to work with your family doctor at this step to decide on the proper lifestyle change or pharmaceutical drug to take. With time, the major changes that have occurred at the back of the eye may be reversed and, as long as the blood pressure is controlled, should not recur. This of course depends on the case and the duration of time that the blood pressure was elevated for. In cases of extremely high blood pressure, one will need to visit the emergency room immediately and intravenous hypotensive drugs will be needed.