How can diagnose type of hypertension from eye examination

 

You can easily know if the patient has acute or chronic hypertension through.

Signs of Acute hypertension crisis

 

1) Choroidopathy :

• Elschning spots small black spots surrounded by yellow hallos which represent focal choroidal infarcts.

• Siegrist streaks flecks arrange of linearly infarcts along choroidal vessels indication of fibroid necrosis.

Macular function

 

Macular function with clear

1. Visual acuity
2. Pupillary reaction.
3. Colour vision test.
4. Ophthalmoscopy.
5. Slit lamp biomicroscopy.
6. Amsler grid test .
7. Photostress test.

Macular test with opaque

The methods of assessment of the ocular blood flow

 

A)   The technique used in experiment animal:

1. Intravascular microsphere injection.
2. hydrogen clearance.
3. Krypton washout.
4. labile liposomes.

B)   Flurescenin fundus angiography and ICG angiography.

1. Pulsatile ocular blood flow calculations.
2. Doppler  color imaging.

Arteriosclerosis

 

• It is the presence of changes at A-V crossings ( AV nipping ).
• It is not indicative of severity of hypertension but indicative for long time ( many years ).

 

Grad 1      Subtle broadening of the arteriolar light reflex mild

Hypertensive Retinopathy

 

The response of retinal  arterioles  to  systemic hypertensive include :

1- Vasoconstriction:

hypertensive narrowing is seen in its pure  form only in young patients.

2- Disruption of inner blood – retinal barrier :

leading to increase vascular permeability  causing:

• flame – shaped retinal hemorrhage.
• retinal oedema.
• hard exudate.