Hypertension can damage your eyes


Hypertensive Retinopathy

Hypertensive Retinopathy (HR) is a result of damage to the back of the eye, due to hypertension (high blood pressure). Typical signs of HR include narrowing of the small arteries and arterioles and haemorrhages which eventually lead to a noticeable loss of vision. Systemic hypertension may be undiagnosed, and an eye exam can often yield the first signs of it.

HR is one of the leading causes of preventable blindness. Visits to your eye care practitioner are essential to detect and monitor changes.

The main symptom of Hypertensive Retinopathy is altered vision.

These are some of the things your eyecare practitioner may see:

  • Tortuosity (twisting) of the retinal blood vessels.
  • Retinal arteries and veins start to cross.
  • Haemorrhaging (bleeding) in the retina.
  • Cotton wool spots: Yellowish areas of the retina from lack of blood flow.
  • Deposits (lipids, or fats, that have leaked from the blood vessels).
  • Retinal edema (swelling of the retina in other areas), which can lead to retinal detachment.
  • Papilledema (swelling of the optic nerves); a condition that requires immediate hospitalisation.

Most people with hypertensive retinopathy do not have symptoms until late in the disease.

Patients who have acute malignant hypertension often complain of eye pain, headaches, or reduced vision.

Hypertensive Retinopathy is caused by an increased blood pressure (BP) in the blood vessels within the retina. The higher the blood pressure and the longer it has been high, the more severe the damage. You have a higher risk of damage and vision loss when you have diabetes, high cholesterol level, or you smoke.

Currently, treatment for patients with stage 1, 2 or 3 HTR includes close observation, management of high blood pressure and regular retinal exams. Malignant HTN, however, is a clinical emergency that warrants immediate referral for proper anti-hypertensive treatment.

If the condition is diagnosed during stage 1 or 2, the progress to stages 3 and 4 Hypertensive Retinopathy can easily be prevented by:

  • Managing the systemic blood pressure with any wide-range of treatment options available
  • Administering injections to the eye to control swelling and preserve vision (in the case of macular edema).
  • Repair/reattachment of the retina via surgery; in case of retinal detachment.

* Content courtesy Kenton Optometrists.


  1. Cataracts
  2. Glaucoma
  3. Macular degeneration
  4. Blepharitis
  5. Diabetic retinopathy
  6. Hypertensive retinopathy

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