What is Hypertensive retinopathy?

Hypertensive retinopathy (HR) occurs when high blood pressure damages the blood vessels in the retina, the light-sensitive layer at the back of the eye. Over time, this can affect vision and overall eye health.

Common symptoms of HR

• Blurred Vision: Due to swelling of the retina or damage to retinal blood vessels.
• Reduced Visual Acuity: Vision may deteriorate gradually or suddenly in severe cases.
• Floaters or Spots in Vision: Caused by possible retinal hemorrhages.
• Double Vision or Headaches: Common in advanced stages and optic nerve involvement.

Note: Regular monitoring is essential in preventing vision loss and detecting issues early.

Disease progression

Grade 1 - Mild HR

Smaller blood vessels at the back of the eye (retina) become slightly narrowed, and some areas look shinier than normal.

Grade 2 - Moderate HR

More pronounced narrowing than before and some arteries are pressed against nearby veins, causing them to look pinched, known as AV nicking.

Grade 3 - Severe HR

Signs of retinal bleeding and small fluffy white spots caused by reduced blood flow. Some areas also have fatty deposits leaking from damaged blood vessels.

Grade 4 - Malignant HR

The optic nerve is swollen with bleeding, white spots, and leaking blood vessels in the eye. This is a serious condition and is considered a medical emergency.

Stats & Incidence

• Increases with age and duration of hypertension.
• 75% prevalence of mild HR in Malawi.
• Affects approximately 27.4% of men and 26.1% of women in South Africa.

Treatment & Management

The best way to manage hypertensive retinopathy is by controlling blood pressure through medication, lifestyle changes, and regular check-ups. Routine eye exams can help detect early signs and prevent further damage.