Hypertension, or high blood pressure, is a growing health concern globally, particularly in India, where one in every five individual is found to be hypertensive. While many people are familiar with the impact of high blood pressure on the heart and blood vessels, its effect on vision is less commonly understood. Dr Ajay Sharma, Founder and Chief Medical Director of Eye-Q Eye Hospitals says elevated blood pressure can cause hypertensive retinopathy, a condition where the increased pressure harms the delicate blood vessels within the retina, leading to potential vision problems. "As hypertension silently progresses, so too can hypertensive retinopathy, often without noticeable symptoms in its early stages," says the doctor.
Retinal Vessel Damage
The retina depends on a steady flow of oxygen-rich blood to function properly. However, high blood pressure puts excessive strain on the small blood vessels responsible for this circulation. Over time, as hypertension continues, these vessels stretch, narrow, and weaken. "This deterioration can cause fluid or blood to leak into the retina, resulting in blurred vision. Some individuals may also experience double vision, headaches, and progressively worsening eyesight," says Dr Shrama. He also warns that the longer high blood pressure goes unmanaged, the more severe the damage becomes, increasing the likelihood of complications.
Progression and Severity
Hypertensive retinopathy progresses through various stages, with symptoms worsening over time. A study revealed that nearly 49.33% of individuals with high blood pressure develop hypertensive retinopathy. "Men are more frequently affected (62%) compared to women (38%). In the early stages, subtle changes to the retinal vessels may not produce any noticeable symptoms. However, as the condition advances, the vessels may leak or even rupture, leading to more severe visual impairments," reveals the doctor. Nearly 43.24% of cases are mild, while 56.74% fall into the moderate-to-severe category. "More advanced cases can lead to retinal vein occlusion, where blocked vessels prevent normal blood flow, further impairing vision," he adds.
Macular and Optic Nerve Damage
In advanced hypertensive retinopathy, other crucial parts of the eye, like the macula and optic nerve, can also be affected. "Fluid buildup in the macula, known as macular edema, can cause vision distortion, making it hard to see fine details," says Dr Sharma. Further, the optic nerve, which transmits visual information from the retina to the brain, can also sustain damage, potentially resulting in permanent vision loss.
"It’s essential for those with high blood pressure to schedule routine eye exams. Catching the condition in its early stages is crucial, as managing blood pressure with proper treatment, lifestyle changes, and ongoing observation can notably reduce potential harm. Proactively addressing hypertension is vital for protecting both vision and long-term well-being," recommends Dr Shrama.
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