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There are cases where retinopathy can reach a very advanced stage and cause permanent eye damage that could lead to loss of vision and even a stroke. What do you need to know about this?

Hypertension is a medical condition characterized by elevated blood pressure which, when left untreated, can cause permanent damage to several organs. Aside from the kidneys and heart, which are best-known for being affected by hypertension, there is the risk of developing hypertensive retinopathy.

Hypertensive retinopathy: Causes

When the retina layer (which is located in the back of your eye) is damaged because of high blood pressure, its functions can become limited over time. High blood pressure, a condition that’s normally caused by narrowed blood vessels, can eventually put a lot of strain on the optic nerve.

Retinopathy due to elevated blood pressure isn’t condition that immediately follows the first signs of hypertension. It’s normally a problem that appears when a person has suffered from hypertension for a long period of time, and has failed to treat it.

So, what actually causes hypertensive retinopathy is one of more of the problems that lead to high blood pressure in the first place, such as:

  • Being overweight or obese, as this is one of the leading causes of high blood pressure.
  • Being stressed over a longer period of time, or suffering from anxiety.
  • Having a diet that’s too rich in salt.
  • Not having an active lifestyle.
  • High cholesterol, which is also a cause of an unhealthy diet.
  • Drinking more alcohol than the recommended daily limit (studies have shown that a glass of alcohol can have positive effects, by lowering the blood pressure).
  • Smoking and consuming illegal drugs.
In some cases, hypertensive retinopathy can be caused by an underlying medical condition, such as diabetes, atherosclerosis, or heart disease. Pregnant women are also at risk at having higher blood pressure.

Hypertensive retinopathy: Symptoms and classification

As with a lot of other conditions that are a result of high blood pressure, retinopathy doesn’t show any symptoms until the condition is in a very advanced stage. Normally, people who have a severe form of hypertensive retinopathy will:

  • Have blurred vision, difficulty in seeing.
  • Experience more intense headache episodes, accompanied by double vision.
  • Notice their eyes swelling.
  • See red spots in their eyes, caused by a bursting blood vessel.

Using the Keith–Wagener–Barker classification system, doctors can rate the severity of a person’s hypertensive retinopathy:

  • Grade 1, which is the mildest form of the condition, features a small narrowing of the retinal artery.
  • Grade 2 is more advanced than grade 1, as the retinal artery becomes more constricted.
  • Grade 3 includes all the symptoms of grade 2, but also bleeding in the eyes (retinal hemorrhages), cotton-wool spots, microaneurysms, and retinal edema.
  • Grade 4 is also the most severe stage of hypertensive retinopathy. It features a worsening of the symptoms of grade 3, and also includes macular edema and papilledema (swelling of the optic disc). Patients that are diagnosed with grade 4 hypertensive retinopathy are at a higher risk of a stroke.

Hypertensive retinopathy: What should you know about complications?

Since retinopathy is a condition that involves problems with the eyes, the potential complications are also related to this organ, and may include:

  • Retinal artery occlusions, which occur when blood clots end up blocking the vessels that transport blood to the eyes.
  • Ischemic optic neuropathy, which is the medical term used to describe optic nerve damage.
  • Retinal vein occlusion, which are similar to retinal artery occlusion, only this time the blood clots block the vessels that carry blood away from the eyes.

Hypertensive retinopathy: Diagnosis and treatment

There are typically two common approaches for diagnosing someone with hypertensive retinopathy:

  • The first method uses a device called an ophthalmoscope. With it, your doctor can examine your retina by shining light through the pupil. With this light, the doctor is able to check for signs in the back of the eye, such as narrow blood vessels or possible leaks from those vessels. The procedure is non-invasive, and shouldn't take more than 10 minutes.
  • There is also a test called a fluorescein angiography, and it helps doctors check your retinal blood flow. During this procedure, the doctor uses a special kind of eye drops, which are meant to dilate the pupils. Then, after taking some pictures of your eyes, the doctor injects fluorescein into one of your veins, typically on the inside of the elbow. Once this dye reaches into the eyes’ blood vessels, the doctor will take more pictures for further examination.

The treatment for hypertensive retinopathy involves treating the elevated blood pressure, through the two conventional methods that doctors always employ in such cases.

The first step involves making lifestyle changes, which mostly include adopting a healthier diet, as well as exercising to prevent sedentarism and obesity. This diet doesn’t just imply a higher consumption of fruits and vegetables, but also lowering the quantity of meat consumed per week, minimizing the sugar and salt intake until it’s lower than the recommended threshold, and avoiding the consumption of alcohol.

Quitting smoking is also a crucial part of keeping blood pressure under control, as is stress management. While stress is typically linked with short-term hypertension, being under a constant state of stress will also prolong high blood pressure periods.

The second step in treating hypertensive retinopathy involves a series of medications prescribed by your doctor. Depending on how your organisms reacts to different types of medication, as well as the state of your current hypertension, doctors can prescribe anything from calcium channel blockers, to ACE inhibitors or diuretics.


The best treatment is always prevention, and as far as hypertensive retinopathy is concerned, it’s important to take all measures to prevent blood pressure from rising in the first place. There are cases where retinopathy can reach a very advanced stage and cause permanent eye damage that could lead to loss of vision and even a stroke.

Consider taking your blood pressure on a regular basis to make sure that you can make all required changes before complications such as this one get a change to appear.

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