When you have high blood pressure, the heart has to push with more force than normal against the artery walls to move blood throughout the body. Over time, this force can damage the arteries and interfere with normal blood flow. Hypertensive retinopathy is an eye condition where systemic high blood pressure damages the light-sensitive layer of tissue (retina) at the back of your eyeball that transmits signals to the brain so you can see.
At Retina Specialists, our team of expert ophthalmologists diagnoses and treats all manner of retinal disorders, including hypertensive retinopathy. Because this form of retinopathy is less well-known than, say, diabetic retinopathy, the team wants to take this opportunity to explain how the circulatory system and the eyes interact, so you’ll know when you need to seek medical help.
Your arteries carry oxygen-rich blood and other nutrients from your heart to your body’s tissues. Blood pressure measures the force that blood exerts on your arteries’ walls.
Readings consist of two numbers, reported as one number over the other. The upper number reflects the force when your heart is actively beating. The lower number reflects the force when your heart is at rest. In healthy adults, a normal blood pressure reading should be 120/80 mmHg or lower.
When the readings are higher than these numbers, the heart must work harder to pump the same amount of blood, and this can damage not only the blood vessels but also other organs and even your brain.
In the long term, high blood pressure, or hypertension, causes many of its complications through atherosclerosis. Excess pressure roughens the arteries’ lining, allowing a plaque of fat and debris to build up and narrow them. The heart has to pump even harder to circulate blood, which increases the pressure even more, becoming a positive feedback loop.
Hypertension-related atherosclerosis may lead to:
According to the CDC, in 2021, hypertension was a primary or contributing cause of death for almost 700,000 people in the US. Fortunately, though, you can decrease your risk for all these complications by adjusting your lifestyle.
Your eyes need a reliable blood supply, just like every other part of your body. When you have hypertensive retinopathy, the high pressure disrupts normal blood flow to your retina, damaging parts of the tissue and potentially leading to vision loss and other complications.
Hypertensive retinopathy is a condition in its own right, but it’s also a red flag that you may have blood flow issues elsewhere in your body. That’s because high blood pressure is indiscriminate in which arteries it damages; you may experience complications in many different body parts. These include arteries that supply blood to the heart and brain.
Part of the problem is hypertension is a “silent killer;” it produces no symptoms until it’s quite advanced, at which point it becomes hard to treat. For some people, hypertensive retinopathy is the first indication of a pressure problem, and it means they have a higher risk of developing cardiovascular diseases down the road. These include coronary artery disease and stroke, among others. That’s why it’s so important to have your blood pressure tested regularly.
Hypertensive retinopathy is common among adults over 40 because hypertension is common in this age group as well. Doctors estimate hypertensive retinopathy affects anywhere from 4%-18.7% of adults who don’t have diabetes.
Elevated pressure in the retinal blood vessels makes those vessels tighten for longer than normal (vasospasm). This causes the blood vessels’ openings to narrow and limits how much blood can flow through to the tissue. Over time, the vessels grow stiff and thick, making blood flow even harder until the retinal tissue is damaged to the point that you lose parts of your vision.
Yes, provisionally. With treatment to lower blood pressure, some signs of the retinopathy may go away, but it really depends on how severe your condition is and how early you caught the problem. You have the best chance of reversing damage when the problem is in its earliest stages.
If you haven’t had a blood pressure check or an eye exam in a while, it’s time you take action and come into Retina Specialists for an evaluation of your eye health, including if you’re showing signs of hypertensive retinopathy. Call us at any of our five Texas offices — in Dallas, DeSoto, Plano, Mesquite, and Waxahachie.
