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Hypertensive Retinopathy

By

Sonia Mehta

, MD, Vitreoretinal Diseases and Surgery Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University

Last full review/revision Jun 2020| Content last modified Jun 2020
CLICK HERE FOR THE PROFESSONAL VERSION
Topic Resources

Hypertensive retinopathy is damage to the retina (the transparent, light-sensitive structure at the back of the eye) caused by high blood pressure.

When blood pressure is high (a condition called hypertension High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more High Blood Pressure ), the retina may become damaged. Hypertension damages the small blood vessels in the retina, causing their walls to thicken, which decreases the amount of blood that can flow through them. As a result, the blood supply to the retina is reduced. Patches of the retina may become damaged because the blood supply is inadequate.

As hypertensive retinopathy progresses, blood may leak into the retina. These changes lead to a gradual loss of vision, particularly if they affect the macula, the central part of the retina. Even mild hypertension may damage the retinal blood vessels if it goes untreated for years.

Diagnosis of Hypertensive Retinopathy

  • A doctor's examination of the eye

Using an ophthalmoscope, doctors can observe the typical appearance of the retina in people with high blood pressure. The amount of damage to the retinal blood vessels tends to correlate with the amount of damage to blood vessels in other organs affected by hypertension, such as the brain, heart, and kidneys. When blood pressure is extremely high, doctors may be able to see swelling of the optic disk (called papilledema Papilledema Papilledema is a condition in which increased pressure in or around the brain causes the part of the optic nerve inside the eye to swell. Symptoms may be fleeting disturbances in vision, headache... read more ), indicating the need for immediate treatment (see table Classification of Blood Pressure in Adults Classification of blood pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more Classification of blood pressure ).

Did You Know...

  • The eye is the only organ in the body where doctors can routinely directly observe arteries and deep veins (by using an ophthalmoscope). The appearance of these blood vessels can tell doctors how hypertension and atherosclerosis have affected other blood vessels in the body.

Treatment of Hypertensive Retinopathy

  • Measures to treat high blood pressure

The goal of treatment for hypertensive retinopathy is to lower blood pressure long term. Rarely, when high blood pressure is severe and life threatening, treatment may be needed immediately to save vision and avoid other complications, including stroke, heart failure, kidney failure, and heart attack.

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Eyes, Watery
Eyes may become overly watery in one of two ways. First, a disorder can cause excess tear production. Second, a disorder that blocks tears from draining normally can occur. Which of the following conditions causes watery eyes by blocking tears from draining normally?
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