Hypertensive Retinopathy

The retina is the thin, light-sensitive layer at the back of the eye. It is fed by tiny blood vessels. Long-term high blood pressure (hypertension) can make these vessels narrow, stiff and leaky [1][3].

Doctors can see these blood vessels directly when they look into your eye. This makes the eye a window to the effects of high blood pressure on the rest of the body [3].

What can it lead to?

• Blockage of a retinal vein or artery (retinal vein or artery occlusion), which can cause sudden loss of vision in one eye [1][3]
• Swelling of the optic nerve and retina when blood pressure is very high
• It is also linked to a higher risk of stroke and heart disease [3][4]

Your risk is higher if you [1][2]:

• have high blood pressure, especially if it is not well controlled or has been high for many years
• do not take your blood pressure medicine regularly
• also have diabetes, high cholesterol or kidney disease
• smoke
• are overweight, eat a lot of salt or do little exercise

Most people have no symptoms at all [1]. It is usually found when a doctor or optometrist looks at the back of your eye, sometimes with dilating eye drops or a photo of the retina.

Some people only notice a problem when there is a complication, such as blurred vision or sudden loss of vision in one eye.

High blood pressure itself also often has no symptoms, so the only way to know is to have it checked [2].

Very high blood pressure (sometimes called malignant or accelerated hypertension) can damage the eyes, brain, heart and kidneys within hours to days. It needs emergency treatment [1][3].

The main treatment is to control your blood pressure [1][2]. In most people, the changes in the retina stop getting worse, and early changes can improve.

• Take your blood pressure medicine every day, even when you feel well.
• Check your blood pressure regularly, at your health centre or at home.
• Eat less salt, stay active, keep a healthy weight, and stop smoking.
• Keep diabetes and cholesterol under control too.
• Complications such as retinal vein occlusion may need extra treatment from an eye specialist, such as eye injections or laser.

Where to get help in Brunei

If you have high blood pressure and notice any change in your vision, you can walk in to any Community Eye Clinic at your health centre. No referral is needed.