More than 30% of adults around the world (over 1 billion people) suffer from, or increased blood pressure, most without knowing, according to the World Health Organization. Almost one out of three men in our country may suffer from some form of systemic hypertension! Although it is known primarily as a cause of cardiovascular and renal problems, hypertension can also significantly affect the eyes, causing problems such as hypertensive retinopathy of different stages, even ischaemic choroidopathy, but also visual neuropathy. Also often the diagnosis of systemic hypertension is done first by the ophthalmologist or ophthalmologist. “The basic signs of dredging in ophthalmological evaluation beyond the optic nerve and pale spot are the vascular system: the arteries and associated veins. The transparent construction of the eye – so that it is “processed” images – also gives the unique possibility, from all over our body, to become visible and to be able to easily and intact these vessels within a system of indirect or direct depthscopy lenses. Among other things, we look for signs of damage to their complex vascular system that are characteristic of hypertension. For example, we may see that the blood vessels of the retina have become a little more “difficult” than normal – this occurs with characteristic thickening of the muscle layer of the arteries that makes their appearance “glaze” and reminiscent of silver coating the copper (silver or coper wiring) – one of the most important clinical signs of systemic hypertension – or that they push each other and intersect (av niking), with the arteries limiting and pressing the veins with which they cross. Unfortunately, the initial diagnosis of systemic hypertension by the ophthalmologist is very common when vision is reduced due to ocular vein obstruction (BRVO Branch retinal vein occlusion) and associated cystic macular oedema and this is because hypertension rarely has other apparent symptoms in the sufferers. In more advanced cases – malignant hypertension – we see that there is also a build-up of blood, which looks like tiny bleedings. We can still see tiny aneurysms, retinal spots or macular oedema. These are signs of severe hypertensive retinopathy, a condition caused by damage to the vascular system of the eyes due to persistent increased blood pressure,” explains Dr. Anastasios-I. Kanellopoulos, MD, Surgeon- Ophthalmologist, founder and scientific director of the LaserVision Institute of Ophthalmology, professor of Ophthalmology at NYU University, New York, and adds: “These in the early stages do not cause symptoms, but over time they accumulate and eventually cause lesions on the retina, which is the photosensitive coat of the eyes. At this stage the patient usually has severe retinopathy and may experience blurred or impaired vision, symptoms that are even stronger in those who, apart from hypertension, also have diabetes mellitus. He may also complain of diplopia (see double idols) with headaches. We have to note here that similar vascular changes occur alongside all organs of the body with the same size vessels as: kidneys, neurological system, brain etc. Patients may later exhibit an obstruction of vessels under the retina, the so-called ischemic choroidopathy that can disrupt vision or, sometimes, lead to the creation of scars that disrupt it. These findings are important for pregnant women with hypertension due to the risk of pre-emlampsia or rarer eclampsia. Also, swelling and potential damage to the optic nerve can be caused by blood flow obstruction. In particular, this obstruction causes the death of nerve cells and bleeding within the eye, leading to loss of vision. ” Hypertensive retinopathy is very common and nearly 10% of adults without diabetes mellitus have evidence of its mild form, since a significant proportion of hypertensive patients are irrigated or ill for years without knowing it,” points out Mr. Kanellopoulos adding that “unfortunately, its development often coincides with the occurrence of problems in other internal organs, such as the heart (e.g. hypertrophy of the left ventricle) or kidneys (nephral disease)”. It is a fact that hypertensive retinopathy is a warning indication that direct blood pressure control is required, as in the future the patient is at risk from complications such as stroke or congestive heart failure. In diabetics, moreover, hypertensive retinopathy is a particular risk factor for the development and development of diabetic retinopathy, since hypertension and sugar cumulatively burden the vessels, i. e. the cause of additional retinal lesions due to increased glucose (sugar) blood. “High blood pressure and hypertensive retinopathy usually only cause symptoms when its lesions are widespread,” notes Mr. Kanellopoulos, explaining that “this usually occurs decades after its development, when treating its cause and eye damage is more difficult. However, its early diagnosis may prove to be life-saving for hypertensive people, especially if they do not yet know they are suffering from it or have irregular blood pressure. If you know you have hypertension and suddenly have changes in your vision, contact your eye doctor immediately. It will test you (e.g. ophthalmoscope, fluorangiography) and depending on the findings will make the diagnosis. If you have hypertensive retinopathy, its management is mainly focused on regulating your blood pressure by life-style measures (health-dietary measures) and medication. In this case, cooperation of the ophthalmologist with your family doctor is required. If hypertension has now caused structural damage to the retinal arteries and the tunic itself, these may be irreversible. In this case, your vision will not be improved and the goal of treatment will be not to deteriorate. Therefore, the best solution is to avoid hypertensive retinopathy by regularly measuring blood pressure, exercise, healthy diet and avoiding smoking. If you already know you have hypertension, try to regulate it as best as possible” the professor concludes.
Hypertension: How it affects the eyes
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