Tag Archives: Ophthalmologist

Diagnosis: Hypertensive Eye Disease (Infographic)

Hypertensive eye disease is diagnosed on the basis of a clinical history of #Hypertension and the presence of relevant pathological changes in the eye that are observed via fundoscopy or imaging. https://go.nature.com/3t0PahO

Commentary:

Control of hypertension is one of the triumphs of modern medicine, and there are many effective medications. One of the main problems that I hear about has  to do with taking too much of the medication, and having dizziness, especially on standing, which could cause a fall and injuries.

Abnormalities of the eye with hypertension are common. the doctor can look directly at the bare blood vessels as they course along the back of the eye. A hypertensive artery passing over a vein in the eye compresses it, producing a “nick” that doctors look for. other findings are shown in the info graphic.

These findings help doctors make a diagnosis, but only the rare complications of hypertensive optic atrophy and Choroidopathy actually endanger the vision.

The main organ that seems to suffer the most from hypertension is the heart, which has to work against a heavy load to pump the blood effectively at high pressure. This thickens the walls of the heart, especially the left side, making it less effective. Enlargement of the heart, heart attacks, and heart failure are not uncommon.

The brain is at risk with hypertensive arterial disease, and strokes can be a problem.

Kidney failure is also a real worry.

When you see your doctor for a blood pressure reading, make sure to take off coats and long sleeves. so that the bare arm can be tested. The left arm In right-handed people is preferable, because it has less musculature to shield the artery from compression by the blood pressure cuff.

Be sure you take your medication, if prescribed. The main emergency room visits occasioned by high blood pressure, such as 180/110, is when the patient skips the medication.

—Dr. C.

Eye ‘Floaters’: Posterior Vitreous Detachment

This eye condition usually won’t threaten your vision or require treatment. But it can sometimes signal a more serious, sight-threatening problem. So it’s best to be checked by an ophthalmologist (a specialist who treats eyes) right away.

How can you tell that your vitreous may have detached? By a sudden increase in floaters — those small, typically harmless shapes that drift across your field of vision as you move your eyes.

“Vitreous detachments are pretty common,” says professor of ophthalmology at Cleveland Clinic Lerner College of Medicine Rishi P. Singh, MD. “When you see these new floaters, it’s best to have them evaluated and, specifically, to have a dilated eye examination performed by an ophthalmologist.”

MEDICAL VIEWS: ‘MACULAR DEGENERATION RESEARCH’

Macular degeneration is a leading cause of visual impairment in people over 65 and can lead to blindness. One in three people will eventually suffer some degree of macular degeneration, which is caused by abnormal blood vessels under the retina, the light-sensitive part of the eye. We treat both the more common “dry” as well as the more dangerous “wet” forms of macular degeneration. While there is currently no cure for this disease, we offer the latest treatments to reduce the risk of vision loss and blindness. These include anti-VEGF drugs—which attack proteins that create the abnormal blood vessels that cause macular degeneration—and photodynamic therapy, in which patients ingest medication that is then activated with a laser.

To learn more about macular disease at Yale, visit: https://www.yalemedicine.org/departme…​.

COMMENTARY:

This high quality video shows several aspects of macular degeneration. It discusses treatments with stem cells that are in the research phase; in the future there may be replacements for the abnormal support cells, the vascular cells and pigmented epithelium, that are diseased in macular degeneration.

Current treatment centers on control of abnormal blood vessels either by photo active laser, laser coagulation, or anti-VEGF.
Macular degeneration has two forms, wet and dry. The wet macular degeneration has accumulations, or Drusen, under the epithelium. There are also machines to check the thickness of the macula, which is an aid in diagnosis.

The main symptom of macular degeneration or loss of vision especially in The center of the visual field, which is essential for reading.
As I mentioned in my podcast, I made a posting on macular degeneration that includes an amsler grid. Some early symptoms of macular degeneration include waviness of the lines of this grid. Certainly if you have any visual distortion or loss you should see an ophthalmologist.

If your medical plan permits it, I feel but a regular check buy an ophthalmologist approximately every 6 to 12 months, is very useful. My own ophthalmologist checks my  retinal thickness, optic nerve, pressure and peripheral Field ( to pick up glaucoma) as well as my vision on each visit.

Dr. C.