My Eye Doctor is a Disease Detective: High Blood Pressure and Diabetes

High blood pressure (hypertension) and Diabetes are diseases that affect the blood vessels in your body. These diseases are very common and can affect many organs including the eyes. Since the eye is the only place we can view the blood vessels directly (without surgery), an eye examination can provide a small glimpse into your overall health and identify signs of hypertension and diabetes.

Patient symptoms and signs:

• Fluctuating vision – If the blood pressure or blood sugar spike due to diet or not taking medication as directed, the lens inside the eye can swell or fluid in the retina can actually temporarily change the prescription of the eye.
• Blurry vision – vision which stays blurry could be due to more significant findings including fluid or retinal bleeding (hemorrhages)
• Double vision – more often due to diabetic neuropathy where the disease is actually affecting the nerves which control the muscles around the eye.

Any of these symptoms should be a sign to visit your eye doctor to check the health of your eye and discuss with the doctor managing your high blood pressure or diabetes to determine if a different treatment is necessary.

What does your eye doctor see?

Signs of Hypertensive Retinopathy:

• Arteriolar compression or Venous nicking – when the walls of the arteries thicken they can compress the underlying veins limiting blood flow back to the heart
• Cotton wool spots – white fluffy areas in the retina signifying ischemia (or obstructed blood flow)
• Retinal hemorrhages – due to leaking blood vessels
• Other possible findings: optic nerve swelling, macular edema (fluid)

Signs of Diabetic Retinopathy:

• Venous tortuosity: when the blood vessels supplying the back of the eye become
• Retinal hemorrhages: due to leaking blood vessels
• Retinal exudates: lipids and proteins leaking from weakened blood vessels
• Macular edema: fluid that has leaked out of blood vessels can accumulate in the macula, the most critical area for sharp vision often leading to blurry vision
• Other possible findings: optic nerve swelling, neovascularization (new blood vessel growth)

Treatment

The main goal for any of these findings is to treat or manage the underlying cause which is high blood pressure and/or diabetes. Your eye doctor will report the findings to your primary care doctor or endocrinologist in order to be evaluated for lifestyle changes, start medication, or change medications to better manage your condition. If you have significant hypertensive or diabetic retinopathy and your vision is impacted, treatment with a retinal specialist may be required to reduce further damage to the eyes and preserve vision.

If you have been diagnosed with High Blood Pressure or Diabetes, it is important to evaluate the health of the eyes every year, even if you are seeing well. Call to book an appointment for your comprehensive eye exam today at 954-726-0204 or book online!

AUTHOR

Dr. Isabel Carvajal

Board Certified Optometric Physician

West Broward Eyecare Associates