High Blood Pressure, a general cardiovascular disease, can have repercussions on various body organs, including causing eye disease.
Along with causing problems in the heart and kidney, untreated high blood pressure can also affect your eyesight and lead to eye disease. People with untreated high blood pressure may experience changes in their vision or develop some other eye disease.
High blood pressure can predispose you to a variety of eye problems. Hypertension can cause damage to blood vessels in the retina, where the images focus. The retina is the layer of tissue at the back, in the anatomy of the eye. It changes light and images that enter the eye into nerve signals that are sent to the brain.
This eye disease caused by high blood pressure is known as Hypertensive Retinopathy.
The damage can be serious if left untreated.
Symptoms of Hypertensive Retinopathy
You typically won’t experience symptoms of mild to moderate hypertensive retinopathy. Most people with this eye disease do not have symptoms until late in the disease.
Severe hypertensive retinopathy can occur along with high blood pressure during pregnancy, so prenatal care is important.
It is usually discovered when you get your regular eye check-up.
Symptoms of critical and accelerated hypertension may include:
- Problems in the vision. Such as double vision, dim vision, or vision loss,
- Headaches.
Sudden symptoms must be considered a medical emergency. It often implies that the blood pressure is very high.
Causes of Eye Disease due to High Blood Pressure
Prolonged high blood pressure, or hypertension, is the main cause of eye disease occurring from it.
High blood pressure is a chronic problem in which the force of the blood against the arteries gets too high. The force is due to the blood pumping out of the heart and into the arteries as well as the force created while the heart rests between heartbeats. When the blood moves through the body at a higher pressure, the tissue that makes up the arteries start to stretch and, eventually, become damaged. This causes many problems with time.
Hypertensive Retinopathy generally occurs after the blood pressure has been consistently high over a lengthy period. The blood pressure levels can be affected by:
- a lack of physical activity,
- being overweight,
- taking too much salt,
- a stressful lifestyle.
High blood pressure, is genetic, so you can say, it runs in families.
It is quite common, nowadays, all over the world. Affecting 1 in 3 adults approximately. It’s called a “silent killer” because there are usually no symptoms.
Diagnosis
Your Eye Doctor can diagnose hypertensive retinopathy. She can detect early signs of heart disease during preventive eye exams.
With the use of an Ophthalmoscope.
Ophthalmoscope
This instrument projects light, through the pupil, to examine the back of the eyeball. The ophthalmologist will look for signs of retinopathy, through careful examination of the retina, that includes:
- Narrowing or other small changes of blood vessels,
- Any fluid that may be leaking from the blood vessels,
- Spots on the retina known as cotton wool spots and exudates,
- Swelling of the macula (the center part of the retina) and optic nerve,
- Bleeding in the back of the eye.
This procedure is painless and is over in less than 10 minutes.
Fluorescein Angiography
It is a special test. It may be called for in special cases. Fluorescein Angiography is performed to examine the blood flow in the retina. In this procedure, your Eye Doctor will put special eye drops to dilate your pupils and then take images of your eye. After the first round of pictures, the doctor will inject a dye called fluorescein into your vein. They usually do this on the inside of the elbow. Then further images are taken as the dye moves into the blood vessels of your eye.
Analysis of Hypertensive Retinopathy (HR)
The extent and severity of HR are generally classified on a scale of 1 to 4. As the severity increases, so does the grade. The scale is called the Keith–Wagener–Barker Classification System.
- In Grade 1, there’s a slight narrowing of the retinal artery.
- Grade 2 is similar to grade 1, however, the constrictions of the retinal artery are more severe or tighter. This is called Arterio-Venous, or AV, Nipping.
- The signs of Grade 3 are the same as Grade 2. But there’s also Microaneurysms, Retinal Edema, cotton-wool spots (fluffy white lesions on the retina), and hemorrhages or bleeding in the retina.
- Grade 4 has severe signs of grade 3 along with swelling of the optic disc called Papilledema and Macular Edema. People with Grade 4 HR have a higher risk for stroke and may have kidney or heart disease.
On the lower end of the scale, there may be no symptoms. At grade 4, however, the optic nerve may begin to swell and cause more critical vision problems. High-grade retinopathy tends to indicate serious high blood pressure concerns for this type of eye disease.
Complications of Eye Disease with High Blood Pressure
Patients of HR have a risk of developing complications related to the retina. These include the following:
- Ischemic Optic Neuropathy. It occurs when high blood pressure blocks the normal blood flow to the eyes, damaging the optic nerve. The optic nerve is responsible for carrying images of what we see to the brain.
- Retinal Artery Occlusion. This happens when the arteries that carry blood to the retina become blocked due to blood clots. Therefore the retina doesn’t get enough oxygen or blood. This results in loss of vision.
- Retinal Vein Occlusion happens when the veins that carry blood away from the retina become blocked by blood clots.
- Nerve Fiber Layer Ischemia is the damage to the nerve fibers. And may lead to cotton-wool spots, which are fluffy white lesions on the retina.
- Malignant Hypertension is a rare condition that causes blood pressure to grow suddenly, interfering with working of the eye organ and causing sudden vision loss. This is a potentially life-threatening situation.
People with high blood pressure are also at an increased risk of having a stroke or heart attack. Various studies have established that people with HR were more likely to suffer from a stroke than people without the condition. This was true even for people with blood pressure controlled by medicine or treatment. Further researches have shown that people with HR have an increased risk of both, a stroke and cardiovascular disease.
Treatment for HR
Effective treatment for high blood pressure requires controlling and lowering high blood pressure with a blend of medications and lifestyle changes.
Lifestyle Changes
A diet high in fiber, fruits, and vegetables may help lower blood pressure. Regular physical activity, reducing the intake of salt and limiting caffeine and alcoholic beverages you drink all contribute to healthy blood pressure as well. If you smoke, take steps to quit now. If you’re overweight, you’ll need to lose weight to effectively control high blood pressure.
Medications
Your doctor would prescribe blood pressure medications. You can control this chronic disease by controlling your blood pressure. If the condition is severe, however, you may have irreversible eye damage that causes permanent vision problems.
Prevention
To prevent eye disease due to high blood pressure, it is important that you keep your blood pressure under control. To prevent HR, take steps to avoid high blood pressure:
- reaching and maintaining your optimal weight,
- avoiding smoking and alcohol,
- sticking to the balanced diet as advised by your physician,
- exercising regularly, and
- taking the medications, religiously, as prescribed by your physician.
- you will need to get yourself checked with your doctor regularly for follow-up care.
Also, remember to discuss the condition of high blood pressure with your Eye Doctor.
Summing up
The prediction is worse for higher grades of HR. Grades 3 and 4 are associated with higher rates of:
- stroke,
- heart attack,
- congestive heart failure,
- death.
Grade 4 of HR is also called the “malignant stage”. Patients with uncontrolled hypertension and grade 4 stage, have a generally poor prognosis for survival.
The changes to the structure of arteries in the retina are generally not reversible. Even with treatment, people diagnosed with high blood pressure are at a higher risk for retinal artery and vein occlusions, and other problems of the retina or eye disease.
If you have high blood pressure or HR, you must tell all directions and medications prescribed by your primary care doctor to your Eye Doctor. So that she can work out an appropriate treatment plan. Or they can work unitedly to control your condition.
If you are experiencing vision changes or if it has been more than a year since your last eye exam, you must call +91-8851044355 immediately to book an appointment. Or you can email on eyemantra1@gmail.com.
We specialize in Cataract Surgery, Specs Removal, Retina Surgery and many more.
To know more, please visit Eyemantra.
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