Hypertensive retinopathy refers to the complications that may occur inside the eye with poorly controlled high blood pressure. Most patients with this condition present without visual symptoms and may not even know that they have hypertension. In fact, many hypertensives are first diagnosed during routine eye exams. On a dilated exam the ophthalmologist may see narrowing of the vessels in the retina, hemorrhages and areas of whitening corresponding to poor blood flow. Patients with swelling of the optic nerve may have malignant hypertension, a severe form of high blood pressure with a diastolic (lower number) reading of 120 to 130 mm Hg or more. This condition usually requires immediate hospitalization and an evaluation for the underlying cause of the hypertension.
Treatment for patients diagnosed with hypertensive retinopathy is medical management of the high blood pressure. Those with an underlying treatable cause would be treated accordingly by their primary care physician. Follow-up by an ophthalmologist is typically every few months to yearly.