State Street Blog

What Seniors Should Know About Hypertensive Retinopathy

Written by State Street Assisted Living | Jun 9, 2025 4:00:00 AM

From First State Heritage Park to NASCAR and the Air Mobility Command Museum, Dover, DE, has a wealth of activities for seniors and families. These attractions wouldn't be the same if you couldn't see them. Eye disease in older adults doesn't always get the same attention as other health conditions, but it's equally important for your quality of life.

Hypertensive retinopathy often doesn't have symptoms until the damage is very advanced. You don't have to let this condition limit your vision or lifestyle. Learn more about the connections between high blood pressure and vision and how you can protect your eye health.

What Is Hypertensive Retinopathy?

Hypertensive retinopathy is an eye condition in which high blood pressure damages your retina. The retina is a layer of light-sensitive tissue in the back of the eyeball. It converts light into nerve signals that go to the brain.

High blood pressure makes your blood press too hard against the walls of your arteries. The blood vessel walls get thicker, which causes the vessels to get narrower and restrict blood flow. The retina can be damaged after a long period of high blood pressure because it doesn't receive enough blood flow.

Complications from Retinal Damage and Hypertension

Complications can develop in individuals with retinal damage and hypertension. Related eye issues include:

  • Blockage in an artery that supplies blood to the retina (retinal artery occlusion)
  • Blockage in a vein that drains blood from the retina (retinal vein occlusion)
  • Optic nerve damage (ischemic optic neuropathy)
  • Nerve fiber damage (nerve fiber layer ischemia)

High blood pressure affects blood vessels throughout your body. It can cause problems with your heart and brain. People with hypertensive retinopathy are more likely to have a stroke, according to research published in the Journal of Stroke and Cerebrovascular Diseases.

Symptoms of Hypertensive Retinopathy

Most people don't develop symptoms of retinal damage until the condition is significantly advanced. Symptoms may include:

  • Double or cloudy vision
  • Vision loss
  • Burst blood vessel
  • Eye swelling
  • Headache

Get medical help right away if symptoms start or worsen suddenly. This can be a sign of severely high blood pressure.

Diagnosing Hypertensive Retinopathy

You'll typically need to be examined by an ophthalmologist to be diagnosed with hypertensive retinopathy. The eye care specialist will start by learning about your general health and any history of high blood pressure.

They will then conduct an eye exam. Retinal imaging, like optical coherence tomography, is often part of the exam.

The ophthalmologist may use an ophthalmoscope to look at your retina. This tool shines light through your pupil to the back of your eye, letting the doctor look for signs of blood vessels that are narrow or leaking.

Depending on your condition, the ophthalmologist may perform a fluorescein angiography. It helps show blood flow in the retina. The procedure involves taking pictures of your eye before and after injecting a dye marker into your blood.

Stages of Hypertensive Retinopathy

Healthcare providers use stages or grades to describe how severe a condition is. They usually use a four-grade system to label the stages of hypertensive retinopathy:

  • Grade 1 indicates mild narrowing of the retinal artery
  • Grade 2 has more severe narrowing of the retinal artery
  • Grade 3 shows signs of retinal damage, like bleeding or white patches
  • Grade 4 has severe signs of grade 3 as well as optic disc swelling

Symptoms may be present for patients with a grade 3 condition, but they will be markedly noticeable for patients diagnosed as grade 4.

Risk Factors for Hypertensive Eye Disease in Older Adults

High blood pressure causes hypertensive retinopathy, so the factors that increase the risk of high blood pressure also increase the risk of related eye disease. Older adults are more likely to develop high blood pressure and have a higher risk of developing hypertensive retinopathy.

Many factors can contribute to high blood pressure, including:

  • Lack of physical activity
  • Being overweight
  • Too much salt in the diet
  • Stressful lifestyle

Other risk factors for hypertensive retinopathy include:

  • History of cardiovascular disease
  • Smoking
  • High cholesterol
  • Diabetes and prediabetes

The National Institutes of Health (NIH) reports that high blood pressure is more common in people from certain racial and ethnic groups. Men are more likely to have high blood pressure during middle age, but women are more likely to develop it later in life.

Treatment and Prevention of Hypertensive Retinopathy

The only way to treat hypertensive retinopathy is to lower your blood pressure. Your healthcare provider will usually recommend a combination of lifestyle changes and medication.

Lifestyle changes can include:

  • Maintaining a healthy weight
  • Exercising regularly
  • Limiting alcohol and caffeine
  • Following a heart-healthy diet and reducing your salt intake
  • Stopping smoking

A variety of medications are available to treat high blood pressure, including:

  • Diuretics, which remove excess water and sodium from the body
  • ACE (angiotensin-converting enzyme) inhibitors, which help relax the blood vessels
  • ARBs (angiotensin 2 receptor blockers), which block the chemical that narrows blood vessels
  • Beta blockers, which help the heart beat more slowly and less forcefully
  • Calcium-channel blockers, which help relax blood vessels by preventing calcium from entering their cells

Your healthcare provider will discuss these options with you to find the medication that will work best for you.

Prevention

Avoiding high blood pressure is the best way to prevent hypertensive retinopathy. Making lifestyle changes and taking medication if needed can help you avoid retinal damage. Regular check-ups with your primary healthcare provider and an eye specialist can help identify high blood pressure before complications develop.

A Holistic View of Senior Eye Health

Hypertensive retinopathy can have serious consequences for your vision if left untreated. The best treatment is prevention, which consists of maintaining a healthy blood pressure. Your eyes are an essential part of your health, and they depend on maintaining a generally healthy lifestyle.

Following these senior eye health tips has benefits beyond your vision. For support in your healthy lifestyle choices, you can trust State Street Assisted Living. We provide assisted living and memory care in the heart of historic Dover.

Residents can take advantage of our on-site health and wellness programs, chef-prepared dining, and the support they need to live as independently as possible. Schedule a tour of State Street Assisted Living today to experience the difference our personalized support can make.