Hypertension, when left untreated, can lead to a series of problems and damage to other organs, such as the heart or the kidneys. However, in some situations, high blood flow can also lead to vision problems by interfering with the blood supply that the eyes are meant to receive in order to function properly. While treating high blood pressure can solve most of these issues, failure to do so in time can cause permanent damage.
What is hypertensive retinopathy?
When high blood pressure ends up damaging the tiny blood vessels in your eyes, the resulting condition is named hypertensive retinopathy. The condition can easily be discovered with a regular eye examination. In general, hypertensive retinopathy is accompanied by a series of other symptoms, such as vision problems and headaches.
In the diagnosis process, doctors use an instrument called an ophthalmoscope, which projects lights to the back of the patient’s eyes, looking for signs. Some of these signs include:
- Swelling of the optic nerve
- Bleeding in the back region of the eyes
- Spots on the retina
- Narrowing of the eye’s blood vessels
While there are other vision problems that can occur as a consequence of high blood pressure (more information on them in the following paragraphs), hypertensive retinopathy is the most common one, and is directly related to high blood pressure (the others are more common in patients that suffer from other health problems, such as multiple sclerosis).
Hypertensive retinopathy: Classifications
Hypertensive retinopathy uses a numeric scale to indicate its severity (much like hepatitis C).
- The mildest form of hypertensive retinopathy is classified under grade 1, and is characterized by a small narrowing of the retinal artery.
- Grade 2 indicates a more intensive narrowing of the retinal artery, and is sometimes referred to arteriovenous nipping.
- Grade 3 is a more advanced stage of grade 2, characterized by all of the above, but also retinal edema, lesions on the retina, and bleeding in the eyes.
- Grade 4 includes all of the symptoms of grade 3, alongside optic disc swelling. When a person is diagnosed with grade 4 hypertensive retinopathy, they are greatly exposed to the risk of stroke, heart disease, or kidney damage.
Hypertensive retinopathy: Complications
Hypertensive retinopathy puts people at risk of developing retina-related problem, such as:
- Retinal artery occlusion, which is a consequence of blood clots blocking the arteries and interrupting blood circulation. This prevents the retina from receiving both oxygen and blood. The end result is vision loss.
- Ischemic optic neuropathy is optic nerve damage, as a consequence of hypertension that blocks the eye’s blood supply. Since the optic nerve transmits visual information to the brain, any damage to it can lead to vision impairment.
- Malignant hypertension described severe fluctuations with blood flow, causing pressure to rise suddenly, and interfering with proper visual cues. Malignant hypertension can be fatal.
- Retinal vein occlusion is characterized by blood clots in the vein, which prevents the retina from pushing out blood.
Hypertensive retinopathy: Treatment and prevention
- As far as lifestyle changes are concerned, diet and exercise are the factors that can make a difference. Blood pressure will rise when a person eats fatty foods, drink too much coffee or alcohol, or smokes. People who suffer from high blood pressure should also increase their vegetable and fruit intake as much as possible. Proper exercise and an active lifestyle will push the body to regulate blood flow, improving circulation and decreasing the risk for high blood pressure.
- After a proper medical consultation, the doctor may choose to prescribe a series of blood pressure meds that will keep this condition under control. However, keep in mind that these medications can also bring side effects to the table. Whether you’re taking ACE inhibitors, beta blockers, or diuretics, make sure that you discuss any side effects with your doctor, to examine the possibility of switching to other medication.
Hypertension which is left untreated can also cause a fluid build-up under the retina. The results are distorted vision, as the retina is a sensitive tissue layer which is located in the back of your eyeball.
Hypertensive choroidopathy presents a series of symptoms, such as Siegrist streaks or Elschnig spots. The latter is comprised of visual lesions of a yellow color. Elschnig spots can be healed, but they will leave a pigment spot behind. Siegrist streaks go across the choroidal arteries.
High blood pressure will sometimes manifest itself through blood flow blockages that can destroy nerve cells in the eyes. As a result, someone who suffer from hypertension can have impaired vision, or completely lose their eye functions.
Important note: While hypertension is a condition that can be kept under control with medication and lifestyle changes, severe hypertension is very tricky in its most advanced stages. In such cases, eye damage can be irreversible, as it’s too late for preventive treatment.