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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8321
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I am a 66 year old female who is not overweight and who runs

Resolved Question:

I am a 66 year old female who is not overweight and who runs 3 miles a couple of times a week. I have osteoporosis I am told but have never broken a bone.

In February I had a Branch Rentinal Vein Occlusion in my left eye which means I see blue flashes sometimes. Miniminal amount of sight affected. Not noticeable when using both eyes. I am not diabetic. I am being monitored for 2 years as standard procedure.

The ophthalmologist advised checking out my bp. I have had a 24 hour monitor and average for day is 153/84 and night 128/69. I did have one day time spike of 194 which came straight down again.

My question is - is this blood pressure of the level that should be medicated from the viewpoint of a) the possibility of further eye problems and b) general health. My GP has sort of left it to me but has written a prescription for a diuretic.
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. My name isXXXXX and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

Dr. Rick :

I am a retina specialist and this question comes up more often then you would think it does.

Dr. Rick :

In my professional opinion, given your history of a BRVO and episodes of documented high BP I would suggest that you go ahead and start treating your BP with the help of your GP.

Dr. Rick :

Did you have a fluorescein angiogram after your BRVO?

Dr. Rick :

I would suggest using the diuretic over trusting diet and other means to keep your pressure low enough to prevent future episodes of vein occlusion.

Customer:

I don't know I am afraid. They looked through a slit camera and also had a machine where you could see the blood clot and where it was with the think threads coming off of it. My optician has also just purchased such a machine as well. Is this machine likely to be what you mean. I went to A&E at the Western Eye Hospital in London

Dr. Rick :

Also, if you have not had a follow up eye exam with an ophthalmologist since February you should have one in the near future.

Dr. Rick :

Did they inject dye into your vein and take lots of pictures where you urine was bright yellow afterwards?

Customer:

Oh I went back in March - a month later and I have another appointment for June 19. they said likely I would then be reviewed after 6 months.

Dr. Rick :

Ok. That is a very good follow-up schedule

Customer:

No they did not inject dye into my vein. The opthalmologist kept saying he wasn't worried about my eye because my vision is pretty good but kept saying check out the BP. So really I am ok with the treatment from the eye hospital. My concern really is whether to take the BP tablets as I don't like tablets.

Dr. Rick :

I think you should treat your BP. If you do not like the diuretic, there are other meds available...ask your GP.

Dr. Rick :

But, if you do not treat your BP with medication, I think you are putting yourself at risk for another eye event.

Customer:

I guess I will have to then. I just wondered whether it was 'high' enough to be a risk but in your opinion it is so I will go with that.

Customer:

Thank you for your advise.

Dr. Rick :

That is my thought....

Dr. Rick :

My pleasure. Always happy to help my friends from the other side of the Atlantic :)

Dr. Rick :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick :

Have a good day.

Customer:

Many thanks.

Expert:  Dr. Rick replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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Expert:  Dr. Rick replied 1 year ago.
Let me know if I can do anything else to help. Take care.


It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Customer: replied 1 year ago.

I started strontium citrate for my osteoporosis in January this year. The BRVO occurred just a few weeks later. Could this have been a contributory factor.

I had not previously had a blood clot although in my 20/30s I had intermittent swelling of the calf muscle in one leg and DBT was mentioned
but not confirmed.

Expert:  Dr. Rick replied 1 year ago.
Sally,

No. That should not have affected the chances or the outcome of your BRVO.

Blood clots in the legs are also not involved in BRVO's. These are usually caused from "hardening" of the artery, which crosses over the vein. Since both the vessels are in the same, tight, sheath, the thicker artery "pinches" the vein and cause the vein to back up.

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 1 year ago.

So I think we are saying that the strontium is unlikely to have caused the BRVO. Is that so?

Expert:  Dr. Rick replied 1 year ago.
Sally,

That is correct. Strontium has nothing to do with your BRVO in my professional opinion as a retina specialist.

Don't forget, unless you mash the positive feedback button (the one labeled "excellent" it the most fun to push :) I do not get credit for assisting you.

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8321
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Dr. Rick
Dr. Rick
Eye Doctor
8321 Satisfied Customers
Ophthalmology since 1994 with Retina sub-specialty interest