The finding of hypertensive changes in the eyes may have important implications for a patient’s ocular and general health.
Hypertension is the most common modifiable risk factor for cardiovascular disease, present in a third of the adult Australian population. In the eye, hypertension causes narrowing in the retinal arteriole walls, arteriovenous nicking, retinal haemorrhages and soft exudates (Figures 1 and 2). In severe cases where there is optic disc swelling, patients have malignant hypertension, which may be associated with encephalopathy and cardiac and renal failure. Malignant hypertension is a hypertensive emergency requiring urgent treatment of the patient to reduce organ damage and vision loss (Figure 3).
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