OCULAR MANIFESTATIONS IN HYPERTENSIVE DISORDERS OF PREGNANCY

Pregnancy-induced hypertension (PIH)—encompassing pre-eclampsia and eclampsia—occurs in about 10–15% of pregnancies and can precipitate significant ocular changes ranging from physiological to sight-threatening pathology. In a one-year cross-sectional study (July2023–July2024) at a tertiary care centre in Southern Assam, 100 women (91 with pre-eclampsia and 9 with eclampsia),aged 21–40 (mean around 30years),at a mean gestational age of 36.5 weeks (70% between 28–34 weeks), were evaluated after excluding those with prior systemic or ocular conditions. Routine obstetric data—blood pressure, proteinuria—and ophthalmic evaluations—including visual acuity, intraocular pressure, anterior segment examination, and dilated fundoscopy—were performed. PIH severity was classified per standard definitions: mild (BP >140/90 mmHg, + proteinuria), severe (>160/110 mmHg, ++/+++ proteinuria with systemic symptoms),and eclampsia (onset of convulsions). Results showed mean BP of 155/97mmHg,with proteinuria distributed as 70% '+', 10% '++', and 20% '+++'. Ocular symptoms appeared in 20% of severe pre-eclampsia and all eclampsia patients, predominantly headaches (50%) and blurred vision (24.7%). Anterior segment changes (congestion, haemorrhage, chemosis, oedema) were noted in 12%, always alongside posterior involvement. Fundus abnormalities were present in 47% overall (100% of eclampsia, 38% of pre-eclampsia), exclusively in those with BP >160/110 mmHg, and included arteriolar narrowing (17%), arteriovenous crossing changes (12%), retinal haemorrhages (9%), cotton-wool spots (6%), and papilledema (3%). These findings confirm that hypertensive retinopathy correlates with PIH severity and underscore the importance of routine fundus examination to guide management and prevent vision-threatening complications