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.

What is going on in the body?

The heart, blood vessels, brain, and kidneys control blood pressure. Blood pressure is also controlled by the amount of fluid and salt in the body. Certain hormones in the body can affect both blood vessels and body fluids. The force of the contraction of the heart can also affect blood pressure.

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.

What are the signs and symptoms of the condition?

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.

What are the causes and risks of the condition?

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.

What can be done to prevent the condition?

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.

How is the condition diagnosed?

The diagnosis of hypertensive retinopathy begins with a medical history and physical exam. The healthcare provider 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.

What are the long-term effects of the condition?

If the high blood pressure causing the retinopathy is not treated successfully, the person may lose part or all of his or her vision.

What are the risks to others?

Hypertensive retinopathy is not contagious and poses no risk to others.

What are the treatments for the condition?

Hypertensive retinopathy is treated by lowering the individual's blood pressure. This treatment is outlined in the high blood pressure article.

What are the side effects of the treatments?

Side effects are outlined in the high blood pressure article.

What happens after treatment for the condition?

Effective management of high blood pressure will prevent further damage to the retina.

How is the condition monitored?

The individuals will have regular visits with the healthcare provider to monitor the high blood pressure. Regular eye exams will be done.

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