$Unique_ID{BRK01200} $Pretitle{} $Title{Eye Examination for Hypertension} $Subject{hypertension eyes examination sense senses circulatory arteries blood vessels eye double vision spots blurring pressure high retina retinal artery vein optic optical eyeball eyeballs} $Volume{F-4} $Log{} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Eye Examination for Hypertension ------------------------------------------------------------------------------ QUESTION: I suffer from hypertension. I take note that my physician always looks into my eyes with his instruments, and tells me he can actually tell the condition of my arteries. Can you tell me what he is seeing? I am most curious. ------------------------------------------------------------------------------ ANSWER: The eye is truly the window of the body. It is the only place through which the physician can examine the condition of the blood vessels without actually cutting through the surface of the skin. He can note signs of hypertension when he sees changes in the size and shape of the blood vessels at the back of your eyes. Most patients with hypertension don't develop significant visual problems, but the eye signs may be helpful in managing brain and heart complications that may happen. It is often possible to determine the severity and duration of the hypertension by examining the eye. Narrow, constricted, thickened vessels, leakage of fluid, hemorrhage and retinal degeneration can occur at various stages of hypertension. Double vision, spots in your vision and blurring of vision may be the first sign that your blood pressure is too high. Hypertension can also cause damage to the tiny blood vessels (capillaries) within the retina. The retina, the thin nerve tissue lining the inside of the back of the eye, receives light images and transmits them to the brain, creating vision. The first response of the little retinal arteries to hypertension is narrowing. If high blood pressure quickly returns to normal, the retinal vessels return to their normal state. Uncontrolled, severe and long-standing high blood pressure can cause retinal damage and vision loss. When the tiny retinal blood vessels become hardened from years of hypertension, the retina cannot get adequate oxygen or nutrition. These damaged blood vessels can rupture, causing hemorrhage into the eye. A sudden appearance of spots or streaks in your vision is caused by blood leaking from the retinal vessels. In addition to blood vessels hardening and narrowing, vessel walls become thicker after many years, hindering the smooth flow of blood to the retina and pressing on veins that cross them, thus blocking normal blood return. Blurring of vision may occur from blockage in either a retinal artery or vein. Your physician is practicing good medicine with his regular eye checks. Resources: Glasspool, M. Eyes: Their Problems and Treatments. NY: Arco, 1984, p. 98-100. Michelson, P. Insight into Eyesight: The Patient's Guide to Visual Disorders. Chicago, Nelson-Hall, 1980:173,176. Madias, NE. What You Can Do About High Blood Pressure. Wellesley, MA: Arandel, 1978:27. Walsh, JB. The ocular fundus mirrors its severity. Consultant 29:92-104, 1989. Becker, RA. Hypertension and arteriosclerosis, in: Duane. Clinical Ophthalmology 1989, (3) 13:1-21. Hedges, TR. Consultation in Ophthalmology. Phila, PA: BC Decker, 1987:183. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.