Can Vision Be Affected By Hypertension?

Hypertension or high blood pressure is not only a common risk factor for heart disease, stroke and kidney disease but also capable of causing eye disease. Hypertension can damage the blood vessels in the retina, which is the area at the back of the eye where images focus. This can limit the retina’s function and put pressure on the optic nerve, thus causing vision problems. The condition is known as hypertensive retinopathy (HR) that can lead to blurred vision or the complete loss of sight. People with hypertension and diabetes are at an even greater risk for developing this condition.

Most people with HR do not have symptoms. It is usually discovered during a routine eye examination or until the condition has progressed extensively. Some possible signs and symptoms may include eye swelling, reduced vision, double vision accompanied by headaches, or vision loss.

The extent and severity of the retinopathy is generally represented on a scale of 1 to 4. In Grade 1, there is a mild narrowing of the retinal artery. Grade 2 is similar to Grade 1, but there is more severe or tighter constrictions of the retinal artery. This phenomenon is known as arteriovenous (AV) nipping. In additional to all the signs of Grade 2, Grade 3 also has retinal edema, microaneurysms, cotton-wool spots (fluffy white lesions on the retina), and retinal hemorrhages (bleeding). Grade 4 has severe signs of Grade 3 along with optic disc swelling called papilledema and macular edema. People with Grade 4 retinopathy have a higher risk for stroke and may have kidney or heart disease.

Patients with HR on the lower end of the scale may not have any symptoms, but for those on Grade 4, their optic nerve may begin to swell and cause more serious vision problems. High-grade retinopathy (Grade 3 and 4) tends to indicate serious blood pressure concerns and is associated with higher rates of stroke, heart attack, congestive heart failure and even death.

A study released in 2013 in journal ‘Hypertension’ reported that HR predicts the long-term risk of stroke, independent of blood pressure, even in treated patients with hypertension with good hypertension control. Another paper published in July 2008 in ‘Journal of vascular and interventional neurology’ suggested the presence of hypertensive retinal vascular changes is linked to higher risk of cardiovascular disease (heart disease and stroke).

Controlling and lowering hypertension with a combination of lifestyle changes and medications are the key for an effective treatment for HR. Lifestyle changes include adopting healthy diet, getting regular physical activity, and reducing salt intake. Smokers should kick the habit and those who are overweight should lose weight. Medications must be taken as prescribed by doctors. Last but not least, patients should go for regular medical examinations to ensure that their blood pressure readings are normal.