Reviewed by: Dr. Matthew Miller, OD on Nov 27, 2020

High blood pressure is often called the silent killer. There are many people who have no idea that they have it because high blood pressure, unless it’s extremely high, often has no symptoms. But, there are tell tale signs that your eye care professional can actually see just by performing a routine eye exam. And it’s important to understand that what’s happening in your eyes is likely happening in the rest of your body.

How do high blood pressure and eyes relate specifically? Can high blood pressure affect vision? Are blood pressure and vision related? Can high blood pressure cause eye floaters? What about “eye” pressure, is that affected by high blood pressure?

These are often questions I hear during my day while seeing patients. First of all, eye pressure and blood pressure are not strongly related, so if you have glaucoma, it’s not because of high blood pressure. However, because your eye is supplied with blood, anything that changes the structure or the function of the blood vessels can damage the eye. This can lead to what eye care professionals refer to as hypertensive retinopathy.

There are different levels of severity in hypertensive retinopathy. In the least severe form, there’s often no high blood pressure eye symptoms, most people have no idea they have it (however, your eye doctor can see it!). In the moderate forms of hypertensive retinopathy, patients may notice blurry spots in their vision— or “floaters”. In the most severe forms, blood, and various blood components, can leak into the retina causing permanent damage to the nerves that transmit the vision signals to the brain. Narrowing and hardening of the arteries can lead to areas of the retina that are not receiving enough oxygen and can essentially die off. The formation of new “leaky” blood vessels can lead to retinal detachments. Extremely high blood pressure can cause your optic nerve to become swollen which can lead to permanent and severe loss of vision.

It might sound somewhat gruesome, but the eye is the only part of the body where we are able to view both blood and nervous tissue directly, without having to perform surgery. Because we are able to view blood related tissues by examining the retina, we can often detect disorders of these tissues. This is yet another reason why it’s a good idea to get your eyes examined each year. A quick look at your retina can give your eye care professional a lot of information about your overall health. It may even allow them to discover a problem, such as high blood pressure, early on in the disease process. The sooner it’s discovered and treated, the better your prognosis. You won’t know if you don’t go!