High Blood Pressure and Your Retina

High Blood Pressure and Your Retina
What is high blood pressure?
High blood pressure, also known as hypertension, can affect your body and eyes in many
ways. It is important to know what your blood pressure is and to maintain your blood pressure under good control.
Basic Eye Anatomy
Light enters the eye and is focused onto your retina, the lightsensing part of the eye. This information is then transmitted
though the optic nerve to the brain where it is interpreted as
the images you see. Blood vessels play an important role in
maintaining the health of your retina and optic nerve by supplying them with oxygen and nutrients. Arteries and arterioles
bring blood to your tissues and veins drain blood from your
tissues.
What your ophthalmologist sees inside your eyes
When your ophthalmologist examines your retina, they can directly see your retinal blood
vessels. The appearance of these vessels and your retina are excellent markers of the overall
health of your body’s blood vessel system. In fact, the retina is the only place in the body where
your physician can directly see your blood vessels. The retina is one of the organs most sensitive
to sustained hypertension. Subjected to high blood pressure, over time the retinal blood vessels
are damaged and can leak.
Elevated Blood Pressure Can Cause Changes in Your Retina
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Bleeding
Edema and swelling of your retina
Exudation and build up of protein and lipids in the retina
Small infarctions of the retina, also known as “cotton wool spots”
Arteriosclerosis: arteriolar narrowing, artery-vein crossing changes (also know as
"AV nicking"), changes in the color of arterioles and in advanced cases sclerosis of the
blood vessels
Optic nerve swelling and blurred vision
Severe cases of hypertension may result in blockages of the retinal veins or arteries.
These blockages of circulation (called occlusions), can cause severe loss of vision,
even blindness.
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Classic arteriolar
narrowing and AV nicking
Cotton wool spots and
intraretinal hemorrhage
Severe hypertensive
retinopathy with optic nerve
swelling, cotton wool spots
and intraretinal hemorrhages
0.0
0.2
0.4
0.6
0.8
1.0
Optic nerve swelling (papilledema)
What should I do?
Your blood pressure should be optimally controlled under the guidance of your primary
care physician. It is important that you check your blood pressure at home. Obtain a blood
pressure cuff and record your blood pressure daily in a written log. Bring this record with you
when you see your primary care physician and your ophthalmologist. If you have
hypertension you may require medications to lower your blood pressure. Additionally,
optimal blood sugar and cholesterol control are important for maintaining healthy eyes.
If you are a smoker, ask your primary care physician about helping you quit smoking.
Cigarette smoking is a major risk factor for high blood pressure and increases your risk of
retinal blood vessel blockages and macular degeneration.
Regular eye examinations as directed by your ophthalmologist are important to identify and
manage any problems at their earliest stages.
© 2011 Retina Consultants Houston
Branch retinal vein occlusion