Abstract BY PAYING proper attention to certain clearly defined changes in the retina, it is possible for the general practitioner, as well as the ophthalmologist, to make those observations which will permit him to estimate, within reasonable limits of accuracy, the expected level of a patient's diastolic blood pressure, commensurate with these changes. It is well known that during the course of hypertension remissions in blood pressure figures occur. During the periods of exacerbation, on the other hand, there take place such profound, irreversible changes in the appearance of the retinal vessels, particularly the arterioles, that they remain as permanent signs, to be read by him who will. So true is this that, although intercurrent coronary thrombosis will markedly lower the sphygmomanometer readings, it will alter not at all the retinal vessel changes developed during the high diastolic levels that were reached previously. Once a persistently elevated diastolic pressure has existed, References 1. Duke-Elder, W. S.: Text-Book of Ophthalmology , Vol. 3, St. Louis, C. V. Mosby Company, 1941, p. 2724. 2. Gunn, R. M.: Ophthalmoscopic Evidence of (1) Arterial Changes Associated with Chronic Renal Disease; (2) Increased Arterial Tension , Tr. Ophth. Soc. U. Kingdom 12:124, 1892. 3. Keith, N. M.; Wagener, H. P., and Barker, N. W.: Some Different Types of Essential Hypertension: Their Course and Prognosis , Am. J. M. Sc. 197:332-343 ( (March) ) 1939.Crossref 4. Wagener, H. P.; Clay, G. E., and Gipner, J. F.: The Retina in the Presence of Vascular Hypertension , Tr. Am. Ophth. Soc. 45:57-73, 1947. 5. Friedenwald, J. S.: A New Approach to Some Problems of Retinal Vascular Disease , Am. J. Ophth. 32:487-498 ( (April) ) 1949. 6. Wilson, F. M.: Ophthalmoscopic Evaluation of the Hypertensive Patient , J. Kansas M. Soc. 53:225-229 ( (May) ) 1952. 7. Master, A. M.; Goldstein, I., and Walters, M. B.: New and Old Definitions of Normal Blood Pressure: Clinical Significance of the Newly Established Limits , Bull. New York Acad. Med. 27:452-465 ( (July) ) 1951.
A.M.A. Archives of Ophthalmology – American Medical Association
Published: Jun 1, 1954
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