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Symptoms of Hypertensive Retinopathy

  • Hypertensive retinopathy is related to high blood pressure
  • Hypertensive retinopathy is graded according to seriousness
  • Ophthalmic examination may reveal flame shaped hemorrhages

Hypertensive retinopathy is a condition where the retina of the eye can be damaged by high blood pressure (hypertension).

Causes and risk factors

Damage is caused to blood vessels within the eyes by high blood pressure. More severe damage is caused as blood pressure increases, or if high blood pressure is a prolonged condition. Signs and symptoms of hypertensive retinopathy can be difficult to detect, although your doctor will be able to use an ophthalmoscope to see whether there is a narrowing of the blood vessels in the eyes, or if the blood vessels are oozing any excess fluid.

A patient with hypertensive retinopathy may not even know that he or she has high blood pressure. In that case, an eye exam may display the first sign of this condition which can be difficult to detect in the early stages. It is most common that hypertensive retinopathy occurs in patients who are middle aged or older. Also, high blood pressure or hypertension is more common among African-Americans than Caucasians. Patients with hypertensive retinopathy in the early stages usually do not display outward signs of the condition, and may not suffer any obvious symptoms.

An ophthalmic examination may reveal flame shaped hemorrhages and cotton wool spots. In rare cases there may be macular or retinal edema (an accumulation of fluid). In more serious cases, there may be a macular star and disc edema. Arteriolosclerosis is often found concurrently.

Hypertensive retinopathy stages graded according to seriousness on a scale of I to IV.

At grade I, hypertensive retinopathy may not display any symptoms, but at grade IV the condition may cause swelling of the optic nerve. It may and may also cause swelling of the visual center of the retina (known as the macula). This swelling can have an adverse effect on the patient’s vision.

Other symptoms of hypertensive retinopathy include visual disturbances and headaches. In the initial stages hypertensive retinopathy can be difficult to detect, although regular testing for signs and syptoms would reveal the condition, either by fluorescein angiography or opthalmoscopic examination. Prolonged high blood pressure may also indicate the condition.

Hypertensive retinopathy is treated by controlling and reducing high blood pressure. This is the only treatment available.


Patients who have severe hypertensive retinopathy (grade IV) may also suffer from kidney and heart complications due to persistent and prolonged hypertension. The retina will usually recover if hypertension is controlled. However, hypertensive retinopathy can cause permanent damage to the optic nerve or macula, particularly if it reaches grade IV.

The complications that are associated with hypertensive retinopathy are generally those that are associated with high blood pressure. However, hypertensive retinopathy may also cause vision problems due to irreversible damage to the macula or optic nerve.

If you have headaches, vision changes or high blood pressure, you should see a doctor or health care professional immediately.

The information supplied in this article is not to be considered as medical advice and is for educational purposes only.

One Response to “Symptoms of Hypertensive Retinopathy”

  1. 1
    Valerie Says:
    Does anyone know exactly what kind of vision problems this causes? I have a friend who was recently diagnosed with this, but she hasn't started experiencing any real problems and we were curious what she was in for.