Did you Know High Blood Pressure Can Affect Your Eyesight

4/1/2021

High blood pressure is bad news: for your heart, your blood vessels and even your eyes. Southwest Eye Consultants explains how untreated high blood pressure can damage the physical structure of your eye.

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Healthy Living in the Four Corners

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is brought to you by

Southwest Eye Consultants.

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You're watching Healthy

Living in the Four Corners.

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I'm Deborah Uroda.

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Philosophers throughout time

have said in one way or another

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that our eyes are the windows

to our innermost selves.

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What they didn't know is that our eyes

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also are a window into our health.

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They are the one organ

where medical professionals

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can look inside the body to

examine the blood vessels

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and nerves that make us tick.

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Durango ophthalmologist Moss Fenberg,

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the Southwest Retina Consultants says

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our eyes also are one of the

first organs to experience

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the effects of high blood pressure.

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The silent killer that, if undetected,

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can lead to heart attacks,

stroke, and eventually death.

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One of the greatest

concerns, outside of eyes,

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is the risk for stroke and heart attack

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with high blood pressure.

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So if you can catch these symptoms early

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when you are seeing it

in the smaller vessels,

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in a place that you

can look into the body,

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in a way that you can't look

into the cerebral vasculature

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or the cardiac vasculature

without an angiographic study,

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and you can say,

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"Listen, I'm not sure that

your blood pressure is under,

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as good control as you think it is."

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Or you can communicate with

a family physician and say,

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"There's significant changes in the eye,

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they are at risk for more

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and more significant systemic problems."

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One of the first signs

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that you may have high blood

pressure or swollen arteries,

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the transportation system that

pumps blood into your eye.

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[Dr. Moss Fenberg] The

artery is what is dealing

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with the higher pressure,

the vein is relatively weak.

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The artery is pulsatile and pressure

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is going through it quite quickly,

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the vein just has valves

and flows passively.

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Arteries cross veins, and as

those arteries cross the vein,

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and the artery is dealing

with a higher pressure,

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the artery crushes the vein,

and that's called AV nicking.

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And so we see that inside the eye,

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arterial venous crossings

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where the vein is just squeezed out

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and the artery is compressing it.

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That's a normal physiologic

response to higher pressure.

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The artery is getting

stronger to deal with that.

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And so when we see those early changes

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that can be an indication

that more changes

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are happening down the road.

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If left untreated, your

high blood pressure

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may manifest itself first, as

a stroke inside the eyeball.

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Stroke is essentially an

interruption of blood flow,

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either because of a bleed

or because of a clot.

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And in the retinal distribution,

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there are several conditions.

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Retinal vein occlusion and

retinal artery occlusion,

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and then there are divisions

of central versus branch.

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And so if you have a central

retinal artery occlusion

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it is a painless, sudden vision loss.

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In the same way that you can have

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a central retinal artery occlusion,

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you can have a branch retinal

artery occlusion, whereby,

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instead of having complete vision loss,

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you have hemifield vision loss,

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one side or the other is lost.

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In general, the treatment for

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a central retinal artery occlusion,

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or a blockage of all the

blood flow to the eye,

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is a ocular procedure here in the office

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that's similar to CPR.

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It's a small effort

with pressure on the eye

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and sometimes a lowering of

the pressure within the eye

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via draining a little bit of fluid

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to push a clot downstream.

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So, if it's in the central

trunk of the vascular tree,

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to try to push it further to

a branch or to a tributary.

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Another complication that may arise

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that if you don't keep your

blood pressure in check,

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is a clogged vein,

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that won't allow the

blood feeding your eye

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to recirculate to the heart and lungs.

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Describe it like a bathtub.

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There's a spigot and there's a drain,

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and there's a faucet and there's a drain.

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Blood is coming in and blood is draining.

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We've obstructed the drain,

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and so the bathtub starts to fill up.

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And so what we see is macular edema,

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the eye gets really marshy

and boggy and swollen,

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and that's very treatable.

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So there are interocular injections,

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I know that terrifies

people to think about

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but there are interocular injections

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where we basically place

a medicine into the eye

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that reverses the body's tendency to leak,

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it suppresses that tendency

for the vessels to leak.

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And so you can treat with

vascular growth factor drugs

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which I know is a mouthful,

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but these growth factor

blocking drugs, suppress that,

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and you can treat with good old steroids

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and those do a great job.

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You can treat with laser,

those help as well.

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Most importantly, what

you don't want to do

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is ever throw the towel in, on your eye.

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Patients often will feel

that, "Okay, I've lost vision,

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I've got the other eye, I've

got the other, I'm fine."

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Well, you're at risk for the

same problem in the other eye.

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And if you live long enough, statistically

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there's a chance that

you'll have that problem.

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We have patients who formerly

had a bad eye and a good eye,

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and then they had a more

serious complication

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in their good eye, and now

their bad eye is their good eye.

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So that's what you

don't want to do is say,

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"Well I've got a good eye still,"

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because you do want to

maintain as much as you can,

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even though it may be your spare tire

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and you may not be relying on it,

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and you wouldn't really want

to have that as your good eye,

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as your only eye.

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You may live another 20 years,

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you may have a problem with your good eye.

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So, important to have follow

up, important to make sure

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that you do limit your

risk, systemic risk factors

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but you also follow the

ophthalmic side of it as well.

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If you'd like to know more

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about the effects of high

blood pressure on your eyes,

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contact Dr. Fenberg at

Southwest Eye Consultants,

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sweyeconsultants.com.

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I'm Deborah Uroda for Healthy Living.

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