Hypertensive retinopathy, causing visual disturbances to blindness

Hypertension or high blood pressure can cause complications in the form of health problems in various organs of the body. In addition to the heart, brain, and kidneys, hypertension can also cause eye problems, ranging from visual disturbances, even blindness. This condition is known as hypertensive retinopathy.

How does hypertensive retinopathy occur?

The retina is a layer of tissue at the back of the eye that functions as a light catcher or receptor. This layer converts the light and images that enter the eye into nerve signals that are sent to the brain, so you can see.

When your blood pressure is high, the walls of the arteries in the retina become thick and narrow, limiting blood flow to this tissue layer. Over time, the damage to retinal blood vessels due to hypertension will damage the visual nerves.

In this condition, the hypertensive retinopathy you experience can cause vision problems, even blindness.

What are the causes and risk factors for hypertensive retinopathy?

Generally, hypertensive retinopathy can occur when your blood pressure is consistently high, which exceeds 140/90 mmHg. The higher the blood pressure and the longer you have the condition, the more likely you are to have serious damage to the eye.

Prolonged hypertension, either essential or secondary hypertension, can occur when you don't control your blood pressure properly. This condition generally occurs when you do not consistently adopt a healthy lifestyle, such as smoking, consuming excessive salt and alcohol, stress, and lack of movement, or do not take high blood pressure medication according to the doctor's requirements.

However, the American Academy of Ophthalmology says, genetic or hereditary factors play a big role in hypertensive retinopathy. The reason is, this case is more often found in someone who has a family history of the same disease.

Apart from those mentioned above, some of the conditions below are also associated with the causes of hypertension, which are also at risk of causing hypertensive retinopathy, such as:

Have heart disease.
Have kidney disease.
Experiencing atherosclerosis.
Have diabetes.
Have high cholesterol levels.
Experiencing obesity or excess body weight.

What are the symptoms of hypertensive retinopathy?

High blood pressure generally does not cause certain symptoms. As with high blood pressure, hypertensive retinopathy generally does not cause symptoms, unless your condition is severe. Signs and symptoms that may arise include:

Decreased vision.
Swollen eyes
Headache.
Double vision.

Apart from those mentioned above, hypertension can also cause blindness if it gets worse. If you feel these symptoms, you should immediately consult a doctor to get the right treatment.

How to detect hypertensive retinopathy?

Diagnosis of hypertensive retinopathy is generally based on two things, namely examination of systemic hypertension and examination of the retina by an ophthalmologist. In systemic hypertension, your doctor will generally check your blood pressure.

Then, the ophthalmologist will detect retinopathy using an ophthalmoscope, which is a device that projects light to examine the back of the eyeball. With this tool, the doctor will look for signs of retinopathy, including:

Narrowing of blood vessels.
Patches on the retina or called "Cotton wool spots".
Swelling of the macula (central part of the retina) and optic nerve.
Bleeding at the back of the eye.

Even with this examination, your doctor will determine the severity of your hypertensive retinopathy. Based on the Keith-Wagener classification, this severity level is divided into four scales, including:

Grade 1

Characterized by narrowing of the arteries in the light part of the retina. In this condition, generally a person has not felt any symptoms.

Grade 2

The presence of more severe narrowing of the retinal artery is accompanied by higher blood pressure.

Grade 3

Characterized by the presence of spotting, bleeding, and swelling of the retina. In this condition, blood pressure is higher and generally there are symptoms that appear, such as headaches.

Grade 4

This scale is generally the same as grade 3, but with more severe conditions. In this condition, there is swelling of the optic nerve and macula. This swelling causes decreased vision.

In addition to the test with an ophthalmoscope, you may need other tests to check your blood vessels. One of the possible tests, that isfluorescein angiography (eye angiography).

This test is done to see the flow of blood in your retina and choroid. This test procedure is done by injecting a special dye into your bloodstream and a camera will take pictures as the dye passes through the blood vessels behind the eyeball.

Can hypertensive retinopathy be treated?

As with systemic high blood pressure, an effective treatment for treating hypertensive retinopathy is to lower your blood pressure through making healthier lifestyle changes and taking regular high blood pressure medications.

In adopting a healthy lifestyle, you need to eat foods high in potassium and fiber, such as fruits and vegetables, and reduce salt intake through the DASH diet guide. In addition, you also need to exercise regularly and regularly, stop smoking, reduce alcohol consumption, and manage stress.

In addition to adopting a healthy lifestyle, your doctor may give you medications for high blood pressure to lower your blood pressure. Some common medications for high blood pressure are diuretics, beta blockers, ACE inhibitors, calcium channel blockers, orangiotensin receptor antagonist.

However, in severe cases of hypertensive retinopathy, the doctor may give drugs intravenously or intravenously. Always consult with your doctor about the right drug for your condition.

Can hypertensive retinopathy be prevented?

Hypertensive retinopathy can still be prevented, even if you have a history of high blood pressure. To prevent this condition, you need to keep your blood pressure within normal limits by adopting a healthy lifestyle as described above.

You also need to take high blood medication regularly, according to the conditions that the doctor gave you. In addition, regular control to the doctor also needs to be done to prevent your hypertension from getting worse.

Prevention of hypertensive retinopathy is very important. The reason is, the condition of retinopathy that is already severe can cause complications of other hypertension, such as heart disease, kidney disease, or stroke.