Greetings to all and sundry,

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It is the start of another week and I believe it marks the start of a blissful week full of many good things to come. I had a great day today with my patients and I am optimistic that my dear readers also had wonderful times in their places of work etc.

![IMG_3939.JPG](https://images.hive.blog/DQmRuhLq2kEFfiijiAGkwjSz57UwDDoYNntKuqWUa6QxmnZ/IMG_3939.JPG)

I am here once again still pursuing my goal of educating my dear readers about the eye and the various conditions that we find ourselves with and how best we can go about protecting ourselves and our sight and by so doing also make the work of eye care providers easier by the day. Today I have an interesting one for us all and I do hope you enjoy the read.

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##### <center> Introduction </center>

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Hypertension is quite a popular condition globally and tends to have one of the highest prevalence amongst the various diseases that are proving to be a canker that the world is battling. It is a condition whereby our systemic pressure goes up and seems to remain high.

Ideally, our pressure is supposed to be around 120/80 mmHg with the initial number representing our systolic pressure (the pressure when the heart pumps blood) and the latter, our diastolic pressure (the pressure when the heart is resting between pumps). But in the case of the hypertension condition, our systolic seems to stay above 140 with the diastolic staying above 90.

![heart-1765298_960_720.webp](https://images.hive.blog/DQmT8SYgGrvhCBLbGYND4TW4gFGZGWiTR5jxzZRug8gF3dL/heart-1765298_960_720.webp)
<center><sub>[image source](https://pixabay.com/illustrations/heart-blood-organ-human-beat-life-1765298/)</sub></center>

Hypertension is a condition that can easily cause one to lose their life because it may not give off any sign or symptom that may push one to visit the hospital. And so a lot of times its diagnosis tends to be via opportunistic screening when one's vital signs are recorded upon their visit to the hospital.

Hypertension causes a lot of damage to our vessels and the other organ systems if the pressure continues to remain quite high without medication. The condition may come about due to aging or as an effect of another condition that one may be battling with including sleep apnea, renal artery stenosis, etc. 

Hypertension if left unchecked could result in a cerebrovascular accident (stroke), cerebral palsies, cardiac infarction, cardiomegaly, erectile dysfunction, etc. The visual system is one of the organ systems that get damaged as a result of hypertension and for our talk today we would be looking at how this happens and what we need to do when we get diagnosed with the condition that could help us save our sight.

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##### <center> Hypertensive Retinopathy </center>

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Hypertensive retinopathy simply refers to the damage that happens to the retina of the eye when we develop hypertension as a condition. The retina continues to remain one of the most active cells/tissues in the human body which means that its need for energy is quite high because of which it is surrounded by lots of blood vessels from the choroid and the other underlying structures.

What hypertension does to the vasculature of the eye is the main cause of hypertensive retinopathy, now because the blood vessels in the eye are quite small when the pressure in them continues to remain high they can easily burst as well as perforate and leak. Again, they can become quite weak and enlarged thus affecting the flow of blood through them, it may even form loops or pools within the vessels.

![image-full (1).jfif](https://images.hive.blog/DQmNVMNMqB3JuZD5WZ3HXsv1JRFh2kWz81SVH4TepN6EkzH/image-full%20(1).jfif)
<center><sub>[image source](https://imagebank.asrs.org/file/16552/papilledema-with-hypertensive-retinopathy)</sub></center>

As the condition progresses blood may ooze out into the eye, thus causing the vitreous to be filled with hemorrhage as well as affecting the release of energy to the retina cells. These cells may die of hypoxia and ischemia which would then have a direct adverse effect on our vision. The blood that gets into the vitreous can also obstruct light passage to the retina which would also affect vision badly.

Hypertension could even cause the optic nerve head to swell if they continue to persist and could eventually lead to painless loss of vision. The best way to diagnose hypertensive retinopathy would be with the ophthalmoscope in a process called funduscopy to assess the integrity of the inner parts of the eye. There are many instances where patients only found out about their being hypertensive from their eye examination

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##### <center> Management/Conclusion </center>

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Because the condition does not stem from the eye but from the general body or the cardiovascular system, it becomes pertinent that tackling it also stems from there as our focusing on the eye only may prove futile. And so the management of hypertensive retinopathy a lot of times tends to be done alongside your general physician.

You may be put on anti-hypertensive drugs to bring the pressure down and if you are already on one and it's not working quite well then it may be changed. Depending on the extent of damage to the eye laser surgery may be done to stop bleeding vessels as well as prevent neovascularization that occurs when the cells become hypoxic.

![IMG_1407.jpg](https://images.hive.blog/DQmV3fK6TMeS4Nj53sadmgsxqPsQXD3oeTGxGAFn8sg8QoJ/IMG_1407.jpg)

Hypertension kill and hypertensive retinopathy may cause you to lose your sight and so do not take it for granted. Have regular ocular examinations if you are a known hypertensive patient and do go an eye checkup if you have just been diagnosed with hypertension. Be sure to be particular about your hypertensive medication, take it as prescribed, and when in doubt, consult your physician.

Love your eyes, love your sight and love your health. Your wealth is very much determined by your health. Remember always that early detection not only saves sight but also lives. Thank you once again for taking the time to read today's discussion, I wish you the very best and I look forward to hearing from you again. Be safe.

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##### <center> Further Reading </center>

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<sub>**Di Marco, E., Aiello, F., Lombardo, M., Di Marino, M., Missiroli, F., Mancino, R., Ricci, F., Nucci, C., Noce, A., Di Daniele, N., & Cesareo, M. (2022). A literature review of hypertensive retinopathy: systemic correlations and new technologies. European review for medical and pharmacological sciences, 26(18), 6424–6443. https://doi.org/10.26355/eurrev_202209_29742.**</sub>

<sub>**Mirshahi, A., Karkhaneh, R., Roohipour, R., Rajabi, M., Vahedian, Z., & Bazvand, F. (2022). Optical Coherence Tomography Angiography Findings in Malignant Hypertensive Retinopathy. Journal of ophthalmic & vision research, 17(3), 432–436. https://doi.org/10.18502/jovr.v17i3.11583.**</sub>

<sub>**Caspers, S., Tran, N. A. P., Delle Fave, M., & Postolache, L. (2022). Rétinopathie hypertensive de grade IV chez une enfant de six ans [Grade IV hypertensive retinopathy in a six-year-old child]. Journal francais d'ophtalmologie, 45(9), 1097–1098. https://doi.org/10.1016/j.jfo.2022.03.031.**</sub>

<sub>**Shrestha, T., , Shrestha, R., , & Kaiti, R., (2022). Study of Characteristic Retinal Findings among Hypertensive Population Attending a Tertiary Care Hospital in Nepal. Kathmandu University medical journal (KUMJ), 20(77), 3–6.**</sub>