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December 22, 2011

Can High Blood Pressure Cause Vision Loss?

High blood pressure is not only bad for your cardiovascular system but for your eyes and vision as well. Blood pressure is the force against the wall of the arteries as the heart pumps blood throughout the body. Hypertension is an increase in blood pressure that affects many organs in the body. What most people don’t realize is that hypertension can occur in your eyes. This is called intraocular pressure. Ocular hypertension usually occurs when the pressure inside the eye is higher than normal. An increase in pressure in the eyes will damage the walls of the small retinal and optic nerve arteries, which can lead to vision loss over time.

Early changes to the retina, as a result of ocular hypertension, include narrowing of the retinal arteries.  As the narrowing progresses, the retinal arteries start to bleed in the form of flame hemorrhages. This causes compression at the points where the arteries cross the retinal veins, called A/V nicking. At this state, total occlusions and large amounts of bleeding in the back of the eye occur. This is retinal damage is known as hypertensive retinopathy.  Irreversible damage and vision loss can result.

As hypertensive retinopathy progresses areas of the retina can become ischemic, which is when there is an inadequate supply of blood to an organ as result of an obstructed blood flow, from lack of oxygen.  Cotton wool spots develop on the retina in the areas of ischemia.  The cotton wool spots typically show advanced hypertensive damage.

In the most advanced stage of hypertensive retinopathy, malignant hypertension, the optic nerve becomes swollen, called papilledema. In these advanced cases only 6% of patients will survive after 3 years.  Treatment for hypertensive retinopathy is the management of systemic hypertension.

Most patients in the early stages of hypertensive retinopathy do not report experiencing any symptoms; therefore, it is extremely important to have yearly eye exams when you have hypertension. Control over your blood pressure with the help of your primary care physician is key in preventing retinopathy.  A healthy lifestyle including a balanced diet, frequent exercise, and maintaining a healthy weight are all factors that can help prevent hypertension and all of its complications.


Dr. Gil Catino


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