Did you know that high blood pressure (also called hypertension) can lead to vision loss? Managing hypertension is essential to avoiding a serious eye condition called hypertensive retinopathy, which results from damage to the blood vessels of the retina. Learn more about the symptoms of hypertensive retinopathy, stages of the condition, and how it's diagnosed and treated.
High blood pressure (also called hypertension) affects nearly 50 percent of adults (about 116 million) in the United States. High blood pressure is defined as systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg. Only about a quarter of those who have high blood pressure are able to keep their blood pressure well-controlled under 140/90. When your blood pressure is too high—and stays that way for prolonged periods of time—it can cause damage to blood vessels throughout the body.
Over time, that damage can lead to an increased risk of heart attack, stroke, heart failure, kidney disease, sexual dysfunction and vision loss. Although all are serious conditions to be managed, we’re going to focus on how poorly controlled hypertension can cause vascular damage to the retina, a condition known as hypertensive retinopathy.
What is Hypertensive Retinopathy?
The retina is the paper-thin layer of light-sensing tissue that lines the back of the eye. The retina’s main job is to convert light into electrical signals, which it sends to the brain via the optic nerve.
The retina relies on nutrients and oxygen from a network of tiny blood vessels, especially small arteries called arterioles. Uncontrolled high blood pressure harms these vessels, causing them to narrow and harden. This decreases overall blood flow to the retina, causing gradual tissue damage that can lead to chronic vision loss.
These other eye conditions can also be caused by high blood pressure, and can occur along with hypertensive retinopathy:
How Common is Hypertensive Retinopathy?
Up to 17 percent of people with high blood pressure—who don’t also have diabetes—experience hypertensive retinopathy. People with diabetes are at an increased risk of a similar condition, called diabetic retinopathy. Having hypertension and diabetes greatly increases your risk of vision loss, which means your eyecare should be managed carefully by an ophthalmologist or medically-trained optometrist.
Certain groups are at higher risk of hypertensive retinopathy. For instance, African Americans and those of Chinese descent are more likely to experience this condition. Additionally, age and gender can also affect risk. For individuals under 65, men are more at risk for hypertensive retinopathy, but for individuals over age 65, women are at increased risk.
How Can I Prevent Hypertensive Retinopathy?
The best way to prevent hypertensive retinopathy is to control your blood pressure. If you have high blood pressure—or are at risk of the condition—you should take steps to manage it with the help of your primary care physician.
Changes that can lower your blood pressure and help keep it under control include:
What are the Symptoms of Hypertensive Retinopathy?
Although damage to your blood vessels builds over time, you may not notice any symptoms until the disease has progressed. The condition is graded on a scale of 1 to 4, depending on how much damage there has been to the vessels and the rest of the retina. At later stages, you may notice:
If you have high blood pressure and experience a sudden vision change or loss of vision, you should seek medical help immediately.
How is Hypertensive Retinopathy Diagnosed?
During a comprehensive eye exam, your eyecare provider uses a special device called an ophthalmoscope. The device shines light into the back of the eye so that your provider can clearly see the blood vessels in the retina. This exam (also called a fundoscopic exam) allows them to look for signs of hypertensive retinopathy such as:
How is Hypertensive Retinopathy Treated?
The primary treatment for hypertensive retinopathy is treating high blood pressure. Work with your doctor on lifestyle changes you can make and medication that can help you effectively manage your blood pressure. If you experience vision loss, it may be possible to treat the retinal edema with laser or an injection to the back of the eye with corticosteroids or antivascular endothelial growth factor drugs such as ranibizumab, pegaptanib, bevacizumab.
What are the Outcomes for People with Hypertensive Retinopathy?
Living with uncontrolled high blood pressure increases your risk of numerous health conditions. If you have hypertensive retinopathy, you also have an increased risk of stroke and heart attack.
Damage already done to the retina cannot be reversed. But by getting your blood pressure under control—especially if you are still in an early stage of hypertensive retinopathy—you can save your vision.
Sources:
American Academy of Ophthalmology
Taking good care of your eyes and your overall health can go a long way toward preventing age-related eye conditions. Eating an eye-healthy diet that includes lots of antioxidant-rich fruits and vegetables slows down the formation of cataracts and reduces your risk of macular degeneration. Getting plenty of exercise and maintaining a healthy weight can prevent diseases like diabetes and high blood pressure--both of which affect vision and eye health. And while you may not be able to prevent the presbyopia (and need for reading glasses) that comes with getting older, your eyecare professional can make sure you get the correct vision correction to see clearly.
The sun’s rays contain damaging ultraviolet (UV) light. The same UV rays that burn your skin and lead to skin cancer also affect your eyes. Staring directly into strong sunlight can damage the retina. And repeated sun exposure over time can lead to cataracts, benign growths on the eyes and even eye cancer. Protect your eyes anytime you’re in the sun by wearing sunglasses that block both UVA and UVB rays.
Some people claim that by correcting your vision with prescription glasses or contacts, you’re weakening your eyes—which then leads to worse vision. Their “proof” is that after wearing your corrective prescription for a while, your vision appears blurrier when you’re not wearing it. But that’s likely because you’re now used to seeing the world in clear, crisp detail—and in contrast, your uncorrected vision appears fuzzier. Getting the proper vision correction for your eyes is essential for your eye health. Don’t try to tough it out if you can’t see clearly. Visit your eyecare professional for an in-person or virtual vision screening.
Not having a bright enough light may make it harder to clearly see the words on the page, but it won’t damage your eyes or permanently impact your vision. Because you’re straining to see, you might get a headache or other symptoms of eyestrain. If you want to read in bed without illuminating the entire bedroom, get a reading light that provides just enough brightness to see your book clearly.
LASIK surgery corrects your distance vision only, so people who are nearsighted benefit most from it. But LASIK doesn’t affect the lens of the eye, the part that helps you focus up close. As you get older, changes to the lens impact your ability to see close up. So even if you have LASIK in your 20s or 30s, you’ll most likely still need reading glasses by the time you hit your 40s or 50s.
Having your face right up next to the bright screen may give you a headache or even cause some temporary eyestrain or fatigue, but it won’t damage your vision. Children are more prone to this behavior than adults—which may be because children can focus close up better than adults can. But if your child can only see the television clearly when sitting close (and has to hold other things close to see them clearly), they may be nearsighted. Taking your child to an eyecare professional for a vision exam will help determine if they need glasses to see clearly.
Most eyecare professionals recommend removing—and thoroughly cleaning—your contacts every night. Even if you use extend-wear lenses that are approved for use a week or month at a time, it’s always safer to give your eyes a nightly break. Your contacts are more likely to accumulate bacteria when you leave them in 24/7, and that can lead to eye infections. Sleeping in your contacts also prevents essential oxygen from getting to your corneas. If you must sleep in your contacts, make it a once-in-a-while event and ask your eyecare provider about contacts that are specially formulated to let more oxygen through.
Carrots (along with other vegetables like sweet potatoes and dark leafy greens) contain high amounts of beta-carotene, which the body converts to vitamin A. Vitamin A is essential for eye health, and a deficiency of the nutrient is the leading cause of childhood blindness in developing countries. In the U.S., vitamin A deficiency is rare, and few people get so little it could impact their eyesight. Also, there’s no evidence that beta-carotene affects the sharpness of your vision or can prevent near or farsightedness. So while getting lots of beta-carotene in your diet may help keep your eyes healthy, no amount of carrots is going to actually improve your vision and allow you to toss out your glasses or contacts.
The jury is still out on how effective blue light glasses are for eyestrain. One recent study found they made no difference in eyestrain symptoms during a two-hour-long computer task. But some experts feel they may help alleviate eyestrain and fatigue during prolonged, cumulative screen time. Either way, blue glasses alone won’t solve the problem of too much screen time. The best way to reduce eyestrain is to limit screen time and take frequent breaks when you do need to spend several hours at your computer.
The jury is still out on how effective blue light glasses are for eyestrain. One recent study found they made no difference in eyestrain symptoms during a two-hour-long computer task. But some experts feel they may help alleviate eyestrain and fatigue during prolonged, cumulative screen time. Either way, blue glasses alone won’t solve the problem of too much screen time. The best way to reduce eyestrain is to limit screen time and take frequent breaks when you do need to spend several hours at your computer.
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