hypertensive retinopathy

Hypertensive retinopathy refers to damage to the retina of the eye that is caused by high blood pressure. The retina is the light-sensing layer of nerves at the back of the eyeball.

 

A person's blood pressure is the product of the amount of fluid and salt in the body, times the contracting force of the heart, times the heart rate, times the amount of resistance in the blood vessels. The kidneys govern the amount of fluids in the body, and certain hormones in the body can affect both blood vessels and body fluids.

 

In most people with high blood pressure, the cause is unknown. In this case, high blood pressure is called primary, or essential, hypertension. When blood pressure is very high for a long period of time, the small blood vessels in the eye undergo a number of changes. The vessels narrow and become constricted in places.

 

Tiny amounts of fluid leak from the blood vessels in the retina. Vision worsens as more and more of the retina is affected by these changes. Sharpness of vision decreases significantly when the central retina, or macula, suffers changes.

 

Hypertensive retinopathy often has no symptoms. In severe cases, it may cause blurred vision. This may come on suddenly or gradually. In very severe cases, vision can be partially or totally lost.

 

Most cases of high blood pressure have no known cause. Some people, however, have risk factors that make them more prone to the disease. When not properly treated, high blood pressure causes damage to the small blood vessels in the eyes as well as to the kidney, heart, and brain.

The American Heart Association has identified both controllable and noncontrollable risk factors for high blood pressure. These factors are discussed in detail in the high blood pressure article. Effective treatment of high blood pressure will lower a person's risk for hypertensive retinopathy.

The diagnosis of hypertensive retinopathy begins with a medical history and physical exam. The healthcare professional will look at the blood vessels in the retina. This is done using a lighted microscope, called an ophthalmoscope. The person's eyes are dilated with eye drops, and the eye is examined.