$Unique_ID{BRK01200}
$Pretitle{Circulatory System}
$Title{Eye Examination for Hypertension}
$Subject{hypertension eyes examination}
$Volume{G-21, G-4}
$Log{
Anatomy of the Eye*0003001.scf
Hypertension*0009601.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


Eye Examination for Hypertension


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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?

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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 arteriolosclerosis, in:  Duane.  Clinical
     Ophthalmology 1989, (3) 13:1-21.
Hedges, TR.  Consultation in Ophthalmology.  Phila, PA:  BC Decker, 1987:183.

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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.
