Unfortunately, yes. Suffering from untreated or poorly controlled high blood pressure for a long time can be detrimental to your eyes. Several eye diseases are directly or indirectly caused by high blood pressure (hypertension). Various hypertension-induced eye damages include:
- Hypertensive retinopathy: Retinopathy means damage to the retina. The retina is the pigmented part at the back of the eye where the image is projected and then, transferred to the brain. High blood pressure can cause loss of retinal blood supply and damage to its cells resulting in vision loss.
- Choroidopathy: Choroid is the collection of blood vessels that supplies blood to the retina. Choroidopathy is built up of fluid in the choroid that lies below the retina. This condition typically occurs in young individuals who experience a sudden episode of the spike in blood pressure. This may be seen in preeclampsia (hypertension of pregnancy), renal hypertension, as well as in cases of tumors secreting substances that can cause blood pressure to rise dangerously.
- Optic neuropathy: Damage to the optic nerve (the nerve connecting the retina to the brain) is seen in untreated or poorly controlled high blood pressure. Optic neuropathy may also be seen if hypertension is overtreated causing episodes of low blood pressure. Neuropathy is the most delirious effect of hypertension and can cause permanent blindness.
Hypertension is also a significant risk factor that aggravates already present eye diseases. The presence of untreated hypertension accelerates the progress of diabetic retinopathy. Individuals with hypertension are prone to develop sudden vision loss due to the formation of blood clots in the retinal vein and the retinal artery. In addition, hypertension may hasten the onset of glaucoma (raised pressure within the eye) causing gradual blindness.
What are the symptoms of eye damage due to hypertension?
The eye damage due to hypertension is gradual, and in many cases, it is painless. Hence, individuals may not seek treatment immediately. It is prudent to be vigilant. The following are warning signs of eye disease in individuals with hypertension:
How do you prevent hypertensive eye disease?
Fortunately, early diagnosis and control of hypertension can halt and even reverse the retinopathy of hypertension. It is advised to get a comprehensive eye checkup done when the hypertension is first diagnosed. This comprehensive examination involves screening for visual acuity, eye pressure, and a fundoscopy to examine the condition of the optic nerve and retina. It is advised to repeat the examination annually to identify and treat the problems in time.
In individuals with an added history of diabetic retinopathy, a test known as a fluorescein angiography may be conducted to investigate the blood flow into the retina. This test takes pictures of the back of the eye before and after injection of a special dye (fluorescein). This test allows us to see if the retinal cells are leaky, swollen, or need proper treatment.
Along with this, lifestyle changes can also halt the progression of retinal damage. The following measures might help you if you already have the symptoms:
- Complete cessation of smoking
- Achieving and maintaining your recommended body weight
- Doing regular physical exercises as recommended. Certain exercises like heavy weightlifting may not be suitable for individuals with active eye disease
- Dietary changes with the inclusion of lots of green-, yellow-, purple- and orange-colored fruits and vegetables
- Cessation of alcohol
Blood pressure medicines like ACE inhibitors, diuretics, angiotensin-2 receptor blockers (ARBs), calcium channel blockers, and beta-blockers are prescribed to help lower blood pressure levels. These medications also help to allow the healing of the retina and stop further damage to eye cells.
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Townsend RR. Ocular Effects of Hypertension. UpToDate. https://www.uptodate.com/contents/ocular-effects-of-hypertension