Pregnancy-induced hypertension syndrome (PIH), characterized by hypertension, edema, and proteinuria, may occasionally present with symptoms such as visual impairment and blurry vision. Ocular findings may include congestion and edema of the eyelid skin and conjunctiva, spasm of conjunctival arterioles, tortuosity of capillaries, and conjunctival pallor, with these vascular changes often occurring earlier than retinal vascular manifestations. In severe cases, conjunctival microvessels may appear serpentine, typically resolving gradually around six weeks postpartum.
Fundoscopic changes may include functional spasm and narrowing of retinal arterioles, followed by increased arterial light reflex; arteriovenous crossing changes, macular star-shaped exudates, retinal edema, hemorrhages, and exudation may also be observed. Severe cases may result in serous retinal detachment or optic disc edema. Serous retinal detachment often reattaches spontaneously within several weeks after delivery. Retinal hemorrhages, edema, exudation, or arteriole sclerosis indicate systemic vascular damage involving the heart, brain, kidneys, and other organ systems.