World Hypertension Day on May 15, 2024: How high blood pressure can destroy your eyesight


Munich, May 2024 – High blood pressure can also damage the vessels in the eye. Prof. Dr. med. Sandra Liakopoulos from the German Ophthalmological Society eV (DOG) on the occasion of World Hypertension Day on May 15, 2024. The DOG expert also gives an outlook on the fascinating findings that artificial intelligence derives from a simple fundus examination.

High blood pressure not only attacks the vessels in the heart or legs, but also damages the arteries and veins in the eyes – and ophthalmologists sometimes diagnose hypertension even before those affected know about it. “A simple examination of the back of the eye with a slit lamp and magnifying glass is sufficient,” explains Professor Dr. med. Sandra Liakopoulos, who works at the University Eye Clinic in Frankfurt am Main and heads the Image Analysis Center for Clinical Studies at the University Hospital in Cologne. “If you have high blood pressure, the vessels in the retina appear narrower, more rigid and they harden,” explains the DOG expert.

Loss of vision can lead to blindness

Even if it doesn’t initially cause pain, high blood pressure needs to be treated. Otherwise there is a risk of changes to the vessels, the retina or the optic nerve, and in more advanced cases even bleeding and infarction. “Such a loss of vision, in which a blood clot blocks a vessel in the eye, is particularly threatening and always an emergency,” emphasizes Liakopoulos. “The vascular occlusion interrupts the oxygen supply to the retina, which can lead to the death of visual cells and thus blindness.” While occlusions of arteries in the eye are rare, venous occlusions are much more common.

Suddenly night in one eye

Different symptoms occur. “When a vein is blocked, the person affected sees increasingly blurred vision in one eye, often as if through a gray haze,” explains the DOG expert. The arterial occlusion, on the other hand, becomes noticeable suddenly. “Then one eye goes black from one moment to the other, and a shadow often covers the entire field of vision,” describes the expert. If left untreated, an arterial eye infarction leads to severe and permanent vision loss in the affected eye in around 95 percent of cases.

Prevent second infarction

If you suddenly no longer see anything in one eye, you should immediately go to a hospital that has an eye clinic and neurology department. “This symptom must be taken very seriously because an eye attack increases the risk of a subsequent cerebral infarction 15 times,” emphasizes Liakopoulos. Doctors therefore examine the carotid arteries and heart and check whether the autoimmune disease giant cell arteritis is present. “In order to protect the second eye from a heart attack or even prevent a brain or heart attack, daily blood-thinning medication is also prescribed,” says Liakopoulos.

Lysis therapy on the eyes is being tested

Even though vision is usually irretrievably lost in the event of an arterial occlusion, lysis therapy can be considered in the first 4.5 hours to restore blood flow in the affected vessel and save vision. “How well the intravenously administered lysis drug works on the blood clot in the eye is currently being investigated in a large study with 30 centers throughout Germany,” reports the DOG expert.

Injections and lasers

If a venous vessel in the eye is blocked, urgency is also required. “If your vision becomes increasingly blurred in one eye, you should consult an ophthalmologist immediately,” advises Liakopoulos. If a vein is actually blocked, various therapies are available to improve vision again. “If water has accumulated in the macula, the central point for visual acuity, anti-VEGF injections can close the leaky vessels again,” explains the ophthalmologist. Laser surgery may be necessary to prevent new, harmful vessels from forming in areas of the retina that are not supplied with blood.

Avoid risk factors

Anyone who wants to protect their eyesight is therefore well advised to minimize risk factors for vascular occlusions. “These include diseases such as high blood pressure, elevated blood lipid levels or diabetes mellitus, which should be well treated,” says Liakopoulos. Lifestyle also helps to avoid heart attacks and thrombosis. “Smoking, regular alcohol consumption, unhealthy diet, lack of exercise and insufficient fluid intake promote vascular occlusions,” explains Liakopoulos. People with risk factors should have their eye fundus examined at least every two years.

High blood pressure, gender, age – everything AI detects

Artificial intelligence (AI) opens up great opportunities here. “It’s fascinating what the AI ​​can calculate from an image of the back of the eye,” says Liakopoulos. The algorithms not only detect vascular changes, high blood pressure and the risk of cardiovascular diseases. “The AI ​​can even determine gender with a reliability of 97 percent and age with an accuracy of three years,” says the DOG expert. In the future, AI could therefore play a major role in screening for general diseases.

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