Most Serious Diseases Can Be “Read” First Through the Eyes

High blood pressure can cause an eye stroke

Dr. Tonya Bozeva is an experienced ophthalmologist with over 10 years of experience. Her scientific interests are in the field of diagnosing and treating retinal diseases, macular degeneration, laser therapy for diabetic retinopathy, vascular retinal diseases, as well as the diagnosis and laser treatment of glaucoma. She has undergone numerous trainings and courses in Bulgaria, Switzerland, Italy, and Portugal. She is a member of the Bulgarian Society of Ophthalmology and the Bulgarian Medical Association.
On World Hypertension Day, we are speaking with her about how high blood pressure damages not just the heart but also the eyes.

Dr. Bozeva, could you explain the connection between arterial hypertension and eye diseases?

Arterial hypertension (high blood pressure) is a condition that, if not treated in a timely and proper manner, can damage the blood vessels in the retina and lead to severe eye damage. Changes in blood pressure affect the caliber of retinal vessels in both directions. Hypertension causes the vessels to constrict and reduces blood and oxygen flow, while hypotension (low blood pressure) causes them to dilate.

Is it true that some serious illnesses can be “read” in the eyes first?

Many conditions in the body, of which we might not even be aware, can be “read” in the eyes. For example, hyperlipidemia often manifests as yellow plaques on the eyelids. Many patients come in for prescription glasses but it turns out that the cause of their unclear vision is not the need for such glasses but changes in the retina, often due to diabetes or parasitic diseases such as toxoplasmosis in the body. Severe autoimmune diseases can also first manifest in the eyes.

How does high blood pressure damage the eyes?

The ‘most harmless’ manifestation of high blood pressure on the eyes is a conjunctival hemorrhage. Patients wake up in the morning with a red eye and come to us very worried. This is most often the result of a sudden rise in blood pressure, typically in the early hours of the day – around 4-5 in the morning. It occurs in people who are aware and are being treated for arterial hypertension, but also in those who are unaware of it, and sometimes this is the first manifestation of high blood pressure for them. This eye condition usually resolves within about 1-2 weeks even without specific treatment and does not damage vision, but we immediately direct patients to a cardiologist for consultation and to determine the conditions leading to external hemorrhaging.

Apart from a heart attack, there is also a condition that can be described as an ‘eye attack.’ What causes it, and what are the consequences?

The so-called ‘eye attack’ is a much more serious and severely vision-impairing condition, caused by the blockage of a retinal vessel. The reasons for this can include numerous conditions – most commonly arterial hypertension, diabetes, arteriosclerosis, kidney diseases, blood disorders, the use of contraceptives. The condition can range from mild vision loss (blurriness) to significant loss of visual field, and in many cases, complete vision loss. The changes in the eye fundus are severe, with extensive hemorrhaging in the retina, damage to the optic nerve, and macular edema.

Treatment of this condition is difficult, prolonged, and requires strict monitoring by an ophthalmologist and a cardiologist. Those most at risk are individuals with severe, poorly controlled hypertension, overweight individuals, and those with other concurrent diseases such as diabetes, high cholesterol levels, high lipid values, etc.

It is recommended that people with arterial hypertension regularly visit not only their cardiologist but also at least once a year an ophthalmologist to prevent severe manifestations of this condition in the eyes and to ensure timely treatment.

Source: SOBAL ‘PENTAGRAM’