Hypertensive retinopathy

Definition

Hypertensive retinopathy is damage to the retina caused by high blood pressure.

Causes

High blood pressure can cause damage to blood vessels in the eyes. The higher the blood pressure and the longer it has been high, the more severe the damage is likely to be.

Your health care provider can see narrowing of blood vessels, and excess fluid oozing from blood vessels, with an instrument called an ophthalmoscope. The degree of retina damage (retinopathy) is graded on a scale of I to IV.

At grade I, no symptoms may be present. Grade IV hypertensive retinopathy includes swelling of the optic nerve and of the visual center of the retina (macula). Such swelling can cause decreased vision.

Symptoms

• Headaches
• Visual disturbances

Exams and Tests

• Ophthalmoscopic examination
• Fluorescein angiography
• Blood pressure

Treatment

Control of high blood pressure (hypertension) is the only treatment for hypertensive retinopathy.

Outlook (Prognosis)

Patients with grade IV (severe hypertensive retinopathy) frequently also have heart and kidney complications of high blood pressure. The retina will generally recover well if the blood pressure is controlled, but some patients with grade IV hypertensive retinopathy will have permanent damage to the optic nerve or macula.

Possible Complications

• Complications associated with high blood pressure
• Irreversible damage to the optic nerve or macula, resulting in vision problems

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) if you have high blood pressure and vision changes or headaches occur.

Prevention

Control of high blood pressure prevents changes in the blood vessels of the eye.

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