<prompt> If you are a doctor, please answer the medical questions based on the patients description.I am 48 years and have high blood pressure for the last 15 years. Now I have also vision problem fundoscopy shows a lot of changes. My blood pressure sometime shoots up to 220145. I am taking a lot of medicines for blood pressure and chest pain. Please advise what to do?.  <response>: Hello! Thank your for asking on Chat Doctor! Regarding your concern, I would explain that uncontrolled high blood pressure can lead to irreversible changes in the retinal artery, causing troubles with the vision. Coming to this point, a better control of blood pressure values would help stop the progression of these changes. You should also know that with such blood pressure values, you are at an increased risk for stroke, heart attack or intracranial bleeding. So, I would recommend discussing with your doctor on the possibility of optimizing your current antihypertensive therapy. Some blood tests are needed to exclude secondary causes of uncontrolled high blood pressure: - complete blood count for anemia-thyroid hormone levels for possible thyroid dysfunction- blood electrolytes for electrolyte imbalance - kidney and liver function tests - fasting glucose and HbA1C. You should discuss with your doctor on the above issues! Kind regards, 