A1. Hypertension related eye conditions

Question 1

what is hypertension?

Answer 1

high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure.

Question 2

state the 3 classes of HT and their systolic and diastolic values

Answer 2

grade 1 HT: 140-159, 90-99
grade 2 HT: 160, 100
critical: >160

Question 3

what is the cause of hypertensive retinopathy?

Answer 3

systemic HT -> retinal arterioles constrict-> Arteriolosclerosis

hardening and loss of elasticity of small vessel walls, manifested most obviously by arteriovenous (AV) nipping (nicking) at crossing points.

Question 4

what will you see in sustained hypertensive retinopathy?

Answer 4

flame-shaped retinal haemorrhages and oedema caused by inner blood-retinal barrier is disrupted, increased vascular permeability

Question 5

what is AV nicking an indication of?

Answer 5

hypertension has been present for many years, even if the BP is currently controlled. Mild AV changes may be seen in the absence of hypertension

Question 6

describe each grade (1-4) of hypertensive retinopathy

Answer 6

grade 1: Slight constriction of retinal arterioles, Non urgent referral to GP

grade 2: Slight constriction of retinal arterioles, with focal narrowing of retinal arterioles and AV nicking. Non urgent referral to GP

grade 3: As above, with cotton wool spots, flame haemorrhages, hard exudates. Urgent referral to GP and Ophthalmologist

grade 4: As above, with disc swelling. Immediate referral

Question 7

what is the 5 mx for HT retinopathy?

Answer 7

Dietary control
Regular medical check and medication
Reduce weight
To monitor retinal changes
Referral to GP / Ophthalmologist for follow-up on other ocular complications.

Question 8

what is hyperlipidemia? what is commonly found in px with hyperlipidemia?

Answer 8

high levels of lipids in the blood.

Atherosclerosis, a disease in which plaque builds up inside your arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.

Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body

Question 9

what are 3 ocular manifestations of hyperlipidemia?

Answer 9

1. xanthelasma
2. arcus
3. hollenhorst plaque (can cause retinal occlusions)

Question 10

differentiate between arteriosclerosis, arteriolosclerosis and atherosclerosis

Answer 10

arteriosclerosis: hardening and loss of elasticity of small arteries/ arterioles vessel walls

arteriolosclerosis: hardening and loss of elasticity of large/medium arteries vessel walls

atherosclerosis: plaque builds up inside your arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.