Most of us think of high blood pressure as a heart problem. It is one, but it doesn't stop there. Your eyes are packed with tiny blood vessels, and they can be some of the first places to show damage.

The tricky part is that early damage often doesn't hurt or blur your vision. You can feel fine and see well while changes are already building at the back of your eye. Here's what to know and what to do about it.

How High Blood Pressure Affects Your Eyes

The retina is the thin layer at the back of your eye that senses light. It relies on a network of very small blood vessels. When your blood pressure stays high for a long time, those vessels are under constant strain. They can narrow, thicken, leak or break.

That means less blood and oxygen reaches the retina, and the optic nerve can be affected too. Doctors call the retina damage hypertensive retinopathy. If you also have diabetes, read our guide to diabetic eye care and regular eye exams. How serious it gets depends on how high your blood pressure is, how long it has been high and whether you have other health conditions.

Eye Problems Linked to High Blood Pressure

Symptoms to Watch For

Many people have no symptoms early on. When symptoms do show up, they can include:

• Blurred vision or vision that comes and goes.
• Dark spots, floaters or flashes of light.
• Double vision.
• Headaches together with changes in your sight.
• Reduced vision in one or both eyes.
• Sudden vision loss, which is an emergency.

Don't wait for symptoms. An eye exam can spot changes before you notice anything. Our World Sight Day post explains why a yearly check is worth it.

Emergency Signs

What Happens at an Eye Exam

If you have high blood pressure, a full eye exam is a good idea. Here's what usually happens.

• Your vision is checked, and your eye pressure may be measured.
• Drops may be used to widen your pupils so the doctor can see the retina clearly.
• The doctor looks at the blood vessels and the optic nerve at the back of the eye.
• Photos or scans of the retina may be taken to record any changes.
• The doctor tells you what they found, and whether your blood pressure doctor needs to know.

The exam is quick and doesn't hurt. If you get drops, your vision may be blurry and light may bother you for a few hours, so bring sunglasses and don't drive afterwards.

Who Should Be Extra Careful?

• You've been told you have high blood pressure.
• You have diabetes, high cholesterol or kidney problems as well.
• You're over 40, or have a family history of high blood pressure or eye disease.
• You're pregnant and have high blood pressure. Your doctor will tell you what to watch for.
• You've noticed changes in your vision, even small ones.

Myths and Facts

How to Protect Your Eyes

Looking after your blood pressure is the best thing you can do for your eyes. Always follow your own doctor's advice.

• Take your medicines as prescribed. Don't stop or change the dose on your own, even if you feel fine.
• Check your blood pressure regularly. Keep a record and share it with your doctor.
• Cut down on salt. Packaged snacks, pickles and papad add up quickly.
• Stay active. A daily walk is a good start, if your doctor agrees.
• Keep a healthy weight and eat plenty of vegetables, fruit and whole grains.
• Limit alcohol and avoid smoking. Both raise the risk of damage to your blood vessels.
• Manage stress and sleep well. Poor sleep can push your blood pressure up.
• Get regular eye exams. Ask your doctor how often you need one.

Does This Affect Your Glasses?

High blood pressure doesn't usually change your glasses prescription. But if your vision turns blurry suddenly, or comes with headaches or other signs, don't assume you need new glasses. See a doctor first. Our guide on the symptoms of a wrong glasses prescription can help you tell a focusing problem from something more serious.

If your eye doctor does prescribe glasses, you can browse our eye frames, and our step-by-step ordering guide shows you how to order.

Frequently Asked Questions

Keep Reading