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Why do we check blood pressure as part of your eye exam?

You may have noticed, at our office, the patient care technician checks your blood pressure as part of your testing during the eye exam.    But why?    What does blood pressure have to do with your eyes or your vision?    The answer:  a lot!

Almost everyone---the news, our doctors, Dr. Oz' talk show, our neighbors, and our spouses--- tell us having high blood pressure can leave you at risk for a heart attack.    But, high blood pressure can also cause changes in the eye that may lead to permanent vision loss.      The reason is that the eye is a highly vascularized tissue.     The retina and optic nerve need a lot of blood supply to function perfectly.   And where there's blood vessels, there's the risk for malfunction due to high blood pressure.

If you've had your eye exam at our office, you may have undergone retinal photos and may remember me pointing out your arteries and veins in the retina.    If a person has chronic high blood pressure, something called Hypertensive Retinopathy may result in these vessels.    When this happens, blood flow is disrupted.   There may be leakage of blood and other fluids into the retina, and other portions of the retina may be cut off from blood flow and the influx of oxygen.    These events carry the risk for permanent damage to the retina.   Depending on the severity and location of this damage, vision loss will be the end result.

In addition, high blood pressure can also lead to a Retinal Vein Occlusion, where the pressure in an artery clamps down on a nearby retinal vein.   The result is that blood already used by the retina can't be recirculated back down to heart.   Instead, it leaks from capillaries and pools in the retina.    Again, the result could be permanent vision loss.    The optic nerve may also be susceptible to chronic high blood pressure, and damage at this part of the eye is just as threatening as the retina.

But, there is an even more valuable reason to check blood pressure.  I firmly believe the optometrist plays an important role in the overall health of an individual.   Sometimes, people may see us every 12 months for their annual eye exam but only see their primary care physician every three years.   If I can let a patient know that her blood pressure is elevated, and she isn't being followed for high blood pressure, then the eye exam has now served as an entry point for this person to take charge of their overall health.

As always, I'd love to hear your comments or questions.

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