Hypertension and The Eye

What is hypertension?

Hypertension is the medical term for high blood pressure. This is a common condition where the pressure inside the blood vessels (arteries) around our body is higher than normal. This means the arteries are under more strain and the heart needs to work harder to pump blood around our body.

Over time, this pressure can cause damage to the arteries as they stretch and become weak. This can lead to complications all over our body including the: heart, brain, kidneys and eyes.

How does hypertension affect the eyes?

Hypertension can cause damage to the arteries in the back of our eye (the retina). This condition is called hypertensive retinopathy.

Hypertension can also increase your chances of developing other eye conditions such as: retinal vascular occlusions, optic nerve damage or diabetic retinopathy (if you are a diabetic).

What are the stages of hypertensive retinopathy?

Your doctor may grade your hypertensive retinopathy: 

  • Grade 1 – Mild narrowing of the arteries
  • Grade 2 – Moderate narrowing of the arteries
  • Grade 3 – Narrowing of the arteries, cotton wool spots (areas with reduced blood supply), haemorrhages (bleeding) and hard exudates (leaking blood vessels)
  • Grade 4 – Severe: all of the above and signs of swelling of the retina or optic nerve

What causes hypertensive retinopathy?

Having high blood pressure for long periods of time increases your chances of developing hypertensive retinopathy.

Common risk factors for high blood pressure include:

  • Increasing age
  • Being overweight
  • High salt intake
  • Sedentary lifestyle
  • Diabetes
  • High cholesterol
  • Family history of high blood pressure
  • Smoking and excess alcohol intake

How will this affect my vision?

In many cases, hypertensive retinopathy does not cause any symptoms.

Some patients may experience: reduced/ blurry vision, double vision or headaches.

If you suddenly experience reduced vision, severe headaches or vomiting then you need to seek urgent help as this may be a sign of extremely high blood pressure. This is a medical emergency called ‘malignant hypertension’.

What is the treatment?

The main treatment for hypertensive retinopathy involves controlling your blood pressure. If your doctor finds evidence of hypertensive retinopathy then they may ask your GP to check your blood pressure and you may be started on medication to control this. It is also important to address any of the above risk factors such as your cholesterol or sugar levels.

Having hypertensive retinopathy may indicate that your high blood pressure has caused damage to other parts of your body, for example: your heart or kidneys. To look for this, your doctor may perform blood tests and other measurements.

If you have another eye condition because of your high blood pressure, such as a retinal vascular occlusion, this may require specialist treatment such as laser treatment or eye injections.

What can I do to improve the health of my eyes?

There are a few things that you can do to help reduce your blood pressure and the risk of damage to your eyes:

  • Follow a healthy balanced diet
  • Regular exercise
  • Weight loss
  • Give up smoking
  • Follow recommended alcohol intake

What do I do if I think I am suffering from hypertension? 

If you are concerned that you may have Hypertension and would like more information do get in touch via the contact page.


NHS Guidelines on Hypertension