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What is Hypertensive Retinopathy?

By Rolando Braza
Updated May 17, 2024
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Hypertensive retinopathy occurs when the blood vessels in the tissue at the back of the eye — the retina — are damaged as a result of blood pressure that is high. The retina focuses an image that a person sees. Damage to the retina usually becomes more severe as the hypertension worsens or when it is prolonged. If a person experiences malignant hypertension, which is the sudden rise of blood pressure to a hypertensive level, he or she may suffer a more serious version of condition.

Damage to the retina caused by hypertensive retinopathy is graded on a scale of 1 to 4. Symptoms at grade 1 may be hardly noticed or felt. Damage in the blood vessels and other parts of the retina may become more evident in grades 2 and 3, while in grade 4 there may be swelling of the optic nerve and vision may become blurred. A person who experiences a headache with blurred or double vision should be immediately brought to the hospital for an urgent treatment.

An eye doctor may perform an ophthalmoscopy, also known as a fundoscopy, in diagnosing hypertensive retinopathy. The procedure employs an ophthalmoscope, a device that allows the doctor to see different parts of the back portion of the eye, including the blood vessels, optic nerve, and the retina. This tool will usually allow the eye doctor to see if there are signs that fluid has started leaking from a blood vessel or if there is a narrowing of a blood vessel.

Fluorescein angiography, also known as eye angiography or retinal photography, may also be used in the diagnosis of hypertensive retinopathy. It uses a camera and a special dye to allow the doctor to take pictures of the eye for analysis. This allows the eye doctor to confirm his or her diagnosis or verify the results of a treatment. The eye test checks if blood flows normally in the choroid and the retina.

Treatment for hypertensive retinopathy largely focuses on treating the underlying cause: high blood pressure. If the patient has not been officially diagnosed with hypertension, he or she should see a doctor to help get the condition under control. It is important for the patient to regularly take maintenance medicines if he or she is diagnosed with hypertension to help maintain a normal blood pressure. The patient may also want to see an eye doctor regularly to maintain a good eye health.

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