High blood pressure is bad news: for your heart, your blood vessels and even your eyes. Southwest Eye Consultants explains how untreated high blood pressure can damage the physical structure of your eye.
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Transcript
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Healthy Living in the Four Corners
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is brought to you by
Southwest Eye Consultants.
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You’re watching Healthy
Living in the Four Corners.
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I’m Deborah Uroda.
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Philosophers throughout time
have said in one way or another
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that our eyes are the windows
to our innermost selves.
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What they didn’t know is that our eyes
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also are a window into our health.
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They are the one organ
where medical professionals
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can look inside the body to
examine the blood vessels
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and nerves that make us tick.
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Durango ophthalmologist Moss Fenberg,
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the Southwest Retina Consultants says
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our eyes also are one of the
first organs to experience
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the effects of high blood pressure.
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The silent killer that, if undetected,
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can lead to heart attacks,
stroke, and eventually death.
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One of the greatest
concerns, outside of eyes,
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is the risk for stroke and heart attack
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with high blood pressure.
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So if you can catch these symptoms early
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when you are seeing it
in the smaller vessels,
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in a place that you
can look into the body,
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in a way that you can’t look
into the cerebral vasculature
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or the cardiac vasculature
without an angiographic study,
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and you can say,
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“Listen, I’m not sure that
your blood pressure is under,
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as good control as you think it is.”
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Or you can communicate with
a family physician and say,
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“There’s significant changes in the eye,
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they are at risk for more
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and more significant systemic problems.”
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One of the first signs
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that you may have high blood
pressure or swollen arteries,
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the transportation system that
pumps blood into your eye.
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[Dr. Moss Fenberg] The
artery is what is dealing
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with the higher pressure,
the vein is relatively weak.
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The artery is pulsatile and pressure
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is going through it quite quickly,
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the vein just has valves
and flows passively.
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Arteries cross veins, and as
those arteries cross the vein,
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and the artery is dealing
with a higher pressure,
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the artery crushes the vein,
and that’s called AV nicking.
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And so we see that inside the eye,
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arterial venous crossings
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where the vein is just squeezed out
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and the artery is compressing it.
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That’s a normal physiologic
response to higher pressure.
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The artery is getting
stronger to deal with that.
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And so when we see those early changes
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that can be an indication
that more changes
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are happening down the road.
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If left untreated, your
high blood pressure
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may manifest itself first, as
a stroke inside the eyeball.
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Stroke is essentially an
interruption of blood flow,
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either because of a bleed
or because of a clot.
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And in the retinal distribution,
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there are several conditions.
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Retinal vein occlusion and
retinal artery occlusion,
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and then there are divisions
of central versus branch.
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And so if you have a central
retinal artery occlusion
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it is a painless, sudden vision loss.
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In the same way that you can have
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a central retinal artery occlusion,
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you can have a branch retinal
artery occlusion, whereby,
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instead of having complete vision loss,
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you have hemifield vision loss,
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one side or the other is lost.
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In general, the treatment for
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a central retinal artery occlusion,
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or a blockage of all the
blood flow to the eye,
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is a ocular procedure here in the office
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that’s similar to CPR.
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It’s a small effort
with pressure on the eye
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and sometimes a lowering of
the pressure within the eye
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via draining a little bit of fluid
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to push a clot downstream.
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So, if it’s in the central
trunk of the vascular tree,
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to try to push it further to
a branch or to a tributary.
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Another complication that may arise
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that if you don’t keep your
blood pressure in check,
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is a clogged vein,
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that won’t allow the
blood feeding your eye
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to recirculate to the heart and lungs.
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Describe it like a bathtub.
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There’s a spigot and there’s a drain,
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and there’s a faucet and there’s a drain.
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Blood is coming in and blood is draining.
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We’ve obstructed the drain,
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and so the bathtub starts to fill up.
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And so what we see is macular edema,
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the eye gets really marshy
and boggy and swollen,
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and that’s very treatable.
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So there are interocular injections,
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I know that terrifies
people to think about
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but there are interocular injections
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where we basically place
a medicine into the eye
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that reverses the body’s tendency to leak,
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it suppresses that tendency
for the vessels to leak.
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And so you can treat with
vascular growth factor drugs
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which I know is a mouthful,
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but these growth factor
blocking drugs, suppress that,
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and you can treat with good old steroids
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and those do a great job.
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You can treat with laser,
those help as well.
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Most importantly, what
you don’t want to do
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is ever throw the towel in, on your eye.
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Patients often will feel
that, “Okay, I’ve lost vision,
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I’ve got the other eye, I’ve
got the other, I’m fine.”
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Well, you’re at risk for the
same problem in the other eye.
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And if you live long enough, statistically
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there’s a chance that
you’ll have that problem.
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We have patients who formerly
had a bad eye and a good eye,
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and then they had a more
serious complication
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in their good eye, and now
their bad eye is their good eye.
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So that’s what you
don’t want to do is say,
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“Well I’ve got a good eye still,”
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because you do want to
maintain as much as you can,
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even though it may be your spare tire
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and you may not be relying on it,
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and you wouldn’t really want
to have that as your good eye,
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as your only eye.
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You may live another 20 years,
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you may have a problem with your good eye.
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So, important to have follow
up, important to make sure
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that you do limit your
risk, systemic risk factors
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but you also follow the
ophthalmic side of it as well.
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If you’d like to know more
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about the effects of high
blood pressure on your eyes,
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contact Dr. Fenberg at
Southwest Eye Consultants,
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sweyeconsultants.com.
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I’m Deborah Uroda for Healthy Living.
