High blood pressure and the eye
Among the many general diseases that can have an impact on the eyes, high blood pressure is often the reason for a consultation with an ophthalmologist at the request of the attending physician.
It aims to assess the importance of this hypertension and its impact on the back of the eye in the search for hypertensive retinopathy.
This is a retinal disorder occurring as part of the development of high blood pressure. It is rare and generally asymptomatic.
As the disease progresses, loss of vision in one eye (amaurosis) or both, diplopia (double vision) may occur.
Fundus:
The examination of the fundus is performed with an ophthalmoscope or, preferably, with a non-mydriatic fundus camera, which provides a high-definition digital image of the fundus, often without the need for pupil-dilating eye drops.
The abnormalities detected during the fundus examination allow hypertensive retinopathy to be classified into three stages (Kirkendall classification):
- stage 1: severe and disseminated arterial narrowing,
- Stage 2: The lesions present in stage 1 are found, associated with the **crossing sign**.
- stage 3: we find the lesions present in stage 2 associated with retinal hemorrhages, exudates and cotton wool nodules,
- Stage 4: The lesions from stage 3 are present, associated with **papillary edema**.
These lesions should be distinguished from retinal lesions related to arteriosclerosis, which is much more common.
They, of course, have no relation to the lesions encountered in ocular hypertension in the context of glaucoma, which is an entirely different pathology.