High Blood Pressure & Eyes: Symptoms, Stages, Treatment & Prevention of Hypertensive Retinopathy

Dr. Pakhi Sharma (MBBS)
Dr. Pakhi Sharma (MBBS)

General Physician | 6+ years

High Blood Pressure Eye Symptoms
Living with diabetes, hypertension or any other lifestyle disease is difficult and most often a lonely journey. With Phable, India’s no. 1 BP and Sugar Management Mobile App, you can use technology to take charge of your health. Also Phable’s one-stop-shop is here to help you manage your condition better.

“Eyes are the windows to the soul.” In some cases, they can also be an indicator of your health. The appearance of your eyes and visual symptoms can often be a sign of conditions like stress, clotting disorders, hypertension, and diabetes. What high blood pressure eye symptoms do you need to be on the lookout for? Can you prevent eye damage caused by high blood pressure? Keep reading to learn more.

Contents:
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    Understanding the Effects of High Blood Pressure on Eyes
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    Hypertensive Retinopathy: Signs & Symptoms
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    Hypertensive Retinopathy: Stages
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    Hypertensive Retinopathy: Diagnosis
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    Hypertensive Retinopathy: Treatment
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    Hypertensive Retinopathy: Prevention
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    Hypertensive Retinopathy: Complications
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    When to See a Doctor?
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    Don’t Have Time To Read?
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    FAQs
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Understanding the Effects of High Blood Pressure on Eyes

Hypertension is a condition characterised by the increase in the force exerted by your blood on the inner walls of your blood vessels as it circulates. Prolonged high blood pressure levels can cause damage to the walls of your arteries. This degrades the elasticity of your artery walls. High blood pressure also increases your chances of forming blood clots, which can block smaller blood vessels and restrict blood flow.

 Your eyes are supplied by very small and delicate blood vessels, which can be easily damaged by high blood pressure levels. As a result,  they become narrow and constricted, which hampers the blood flow to your retina (inner tissue of the eye that senses light). 

  • Damaged and weakened blood vessels can also start leaking blood and fluid into the posterior segment of your eye, which can interfere with the light passing to your retina, and also increase the swelling and internal pressure in your eye.
  • When the blood supply to your retina is cut off by damaged blood vessels, your eye starts forming newer, more fragile blood vessels that are more prone to damage by hypertension.
  • When the blood flow to the optic nerve is restricted by a blood clot or damaged blood vessels, it can damage the optic nerve and cause temporary or permanent blindness.

The damage to the blood vessels in the eye caused by high blood pressure is known as hypertensive retinopathy. Having high blood sugar levels, Type 2 Diabetes, or diabetic retinopathy along with high blood pressure levels increases your likelihood of experiencing hypertensive retinopathy.

High blood pressure if accompanied by diabetes, high cholesterol or smoking habits poses a greater risk of damage to the arteries of the eyes leading to vision loss. 

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Hypertensive Retinopathy: Stages

The progression of hypertensive retinopathy can be divided into the following stages based on the extent of damage to your blood vessels and the retina.

  • Stage 1: Slight narrowing of the small and delicate blood vessels in the eye
  • Stage 2: More pronounced narrowing of blood vessels with blood vessel constriction in some areas
  • Stage 3: More obvious narrowing of blood vessels along with leakage of blood and fluid into the eye

Stage 4: Narrowing of blood vessels, leakage of blood and fluid, presence of hard exudates (deposits of fat and protein that settle in the eye), and swelling of the retina and optic disc (the circular area where the retina connects to the optic nerve) caused by fluid buildup.

Hypertensive Retinopathy: Diagnosis

Hypertensive retinopathy can be diagnosed by your ophthalmologist using a simple eye examination. Your ophthalmologist will dilate your eyes using eye drops and look for any structural abnormalities or leaking blood vessels using an ophthalmoscope. Alternately, your ophthalmologist may choose to perform a test called fluorescein angiography, where a dye called fluorescein is injected into your veins to look for blockages or leakage in your blood vessels

Hypertensive Retinopathy: Treatment

The only treatment available for hypertensive retinopathy is to lower your blood pressure levels to the target range set by your doctor. You can lower your blood pressure by taking the following measures.

  • Take all the medication prescribed by your doctor and follow your treatment plan strictly.
  • Eat a balanced, low-sodium or DASH diet.
  • Exercise regularly for at least 30 minutes a day.
  • Lose weight if your body mass index (BMI) is over 25 kg/m2.
  • Manage stress in a healthy way by practising relaxation techniques, yoga, etc.
  • Get at least 7 to 9 hours of sleep every night.
  • Quit smoking.
  • Limit your alcohol and caffeine consumption.

Hypertensive Retinopathy: Complications

Hypertensive retinopathy can cause the following complications.
  • Ischemic optic neuropathy

Occurs when high blood pressure cuts off blood flow to your optic nerve, resulting in damage. The optic nerve carries signals from your eye to your brain where the images are processed. Damage to the optic nerve can result in vision loss.
  • Retinal artery occlusion

Occurs when blood clots block the arteries that supply blood to your retinas. This results in your retina not getting the oxygen and nutrients it needs, which could lead to vision loss in the long term.
  • Retinal vein occlusion

Occurs when blood clots block the veins that carry blood away from your retina. It can lead to leakage of fluid into your retina, along with swelling and increased pressure in your eye. This can damage your retina and lead to loss of eyesight.
  • Retinal nerve fibre layer defects

Reduced blood supply to your eye can damage the nerve fibres that are connected to your retina, causing them to become thin and frayed. This can lead to cotton-wool spots, which present as white patches on the retina. They can cause blurred vision or difficulty seeing colour.
  • Retinal detachment

When the fluid that is leaking from your blood vessels accumulates behind your retina, it can lead to the formation of blisters and scars on the surface of the retina. When this scar tissue contracts along with the blood vessels around it, your retina can detach from the underlying tissues. This can lead to sudden loss of vision.

Hypertensive Retinopathy: Prevention

You can prevent hypertensive retinopathy by keeping your blood pressure under control. Additionally, getting eye examinations every 6 months if you have hypertension can help you catch any signs of hypertensive retinopathy early.

When to See a Doctor?

If you are experiencing any of the serious symptoms of hypertensive retinopathy like blurred or spotty vision, reduced field of vision, or loss of vision, contact your doctor immediately.

Don’t Have Time To Read?

  • Persistently high blood pressure levels can damage your blood vessels, causing them to lose their elasticity. Hypertension can also increase your chances of developing plaque or blood clots, which can restrict blood flow.
  • When high blood pressure causes damage to the blood vessels in the eye that supply blood to the retina and the optic nerve, it is known as hypertensive retinopathy.
  • The progression of hypertensive retinopathy can be divided into four stages based on the severity of damage to the blood vessels and the retina.
  • Hypertensive retinopathy can cause symptoms like blurred or spotty vision, reduced field of vision, double vision, red eyes, swollen eyes, and a loss of vision.
  • Hypertensive retinopathy can be diagnosed through a simple dilated eye examination by your ophthalmologist.
  • Treatment of hypertensive retinopathy includes medication and lifestyle changes to control your blood pressure levels.
  • Complications of hypertensive retinopathy include damage to the optic nerve fibres, loss of blood flow to the optic nerve, detachment of the retina, and obstruction to arterial and venous blood circulation in the eye.
  • Hypertensive retinopathy can be prevented with blood pressure control and regular eye examinations.
  • You should seek immediate medical attention if you are experiencing blurry vision, a reduced field of vision or vision loss.
  • Use the Phable Care App to consult India’s leading cardiologists, order medicines, book lab tests, integrate BP monitors and other devices to get real-time remote care from the comfort of your home. Also, check out our Hypertension Management Program which provides ‎360º care. Let’s treat low/high blood pressure problems together

Frequently Asked Questions

Yes, high blood pressure can damage the blood vessels in your eyes, which can cause them to leak blood into your conjunctive (the white part of your eye). This can cause your eyes to appear red.

Yes, high blood pressure can damage the small and delicate blood vessels that supply blood to various components of your eye like the retina (tissue in your eye that detects light) and the optic nerve.

The most prominent signs of high blood pressure in the eyes are swollen and red eyes. Your ophthalmologist can see more telltale signs of damage like stiffening and hardening of the blood vessels, leaking of fluid and blood into the eye, and damage or changes in the retina during an eye examination.

Yes, damage to the blood vessels and retina in your eyes can cause blurred vision, which can make it harder for you to focus or see clearly. This can strain your eyes and cause tiredness.

Dr. Pakhi Sharma
Dr. Pakhi Sharma, MBBS
(General physician, 6+ years)
An expert in obstetrics and medical emergencies, Dr. Pakhi Sharma, an alumni of Sri Devaraj Urs University of Higher Education and Research Centre, is a general physician working at Phablecare. She has 6+ years of work experience spread across gynaecology and obstetrics, family medicine, and medical emergencies at renowned hospitals and clinics.

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