Tag Archives: hypertension

Ischemic Optic Neuropathy

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globe anatomy
anatomy of the eye (click on image to enlarge)

What is ischemic optic neuropathy?

Ischemic optic neuropathy is condition in which blood flow to the optic nerve is inadequate. The decreased blood flow results in a sudden and sometimes progressive loss of vision. The optic nerve is the nerve that connects the eye to the brain. It sends the “picture” taken by the eye to the brain.

What causes ischemic optic neuropathy?

The cause of ION is not very well understood, but it occurs in people over the age of 40 and may be related to hardening of the arteries (arteriolar sclerosis) caused by high blood pressure, diabetes, high cholesterol, tobacco, or obesity. Some people are predisposed to ION because of the way the eye developed from birth with a small opening in the back of the eye for the optic nerve. This “crowded” optic nerve may be predisposed to blood vessel blockage. Sometimes, ION is caused by an inflammation of the blood vessels (temporal arteritis or giant cell arteritis). Sleep apnea may play a role in some patients and SSRI anti-depressants may be a risk factor.

How is ischemic optic neuropathy managed?

When the doctor diagnoses ION, laboratory tests may be ordered to determine if any underlying problem is present outside the eye. If there are signs of inflammation, a biopsy of a blood vessel over the temple may be performed and treatment with steroid pills instituted if the tests are positive. Most cases of ION are not associated with inflammation. Unfortunately, no treatment has been proven to be effective. The visual loss is usually permanent. Because the fellow eye may be affected at a later date, some doctors recommend the use of a half aspirin a day for prevention.

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.

Copyright © 2017-2022 Designs Unlimited of Florida. All Rights Reserved

Hypertensive Retinopathy

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globe anatomy
anatomy of the eye (click on image to enlarge)

What is hypertensive retinopathy?

Hypertensive retinopathy is the medical name for damage to the retina from high blood pressure. The retina in your eye is like the film inside a camera. The retina “takes the picture” of objects you look at and sends the message to the brain. The retina is a living tissue, which requires blood supplied by tiny vessels. Normally, these blood vessels carry oxygen and nutrients, but do not leak fluid into the retina.

How does blood pressure damage the retina?

High blood pressure puts stress on the walls of blood vessels. In the short-term, high blood pressure weakens the inner lining (endothelium) of the retinal blood vessels causing them to leak serum or blood into the retina. In the long-term high blood pressure may cause permanent blood vessel damage (hardening) leading to retinal vein occlusion or arteriolar macroaneurym.

What are the symptoms of hypertensive retinopathy?

Symptoms may occur early or late in the course of hypertensive retinopathy. Blurring of vision may occur if excess fluid (edema) leaks into the retina. Rarely, blind spots or sudden new floaters may occur. Damage to the retina may occur without symptoms.

What treatment is available?

The key to treating hypertensive retinopathy is to control blood pressure. Lowering blood pressure is associated with lower risk of loss of vision. If complications occur, laser or injections (Avastin, Lucentis, Eylea, Triesence, Ozurdex) may improve the vision by sealing leaky blood vessels. There may be some permanent damage to the retina from high blood pressure. Your doctor is going to order appropriate tests and recommend the best course of action to take at this time. See your internist to keep your blood pressure under good control.

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.

Copyright © 2016-2023 Designs Unlimited of Florida. All Rights Reserved.