Blind Spots Followup

I have a friend who is 36 years old, and has high blood pressure which has been untreated for more than one year  (loss of insurance to be reinstated in one month). Both eyes show distortion on the Amsler Grid. About a year ago he developed his first blind spot in the right eye. It was small, flame-shaped and clearly delineated. He can't see anything through it. If he is looking at a white background with a black marking, the black marking disappears and is white. When reading, a few letters disappear to just above and to the left of his central focus. About six months ago more blind spots appeared, scattered around central focus.

About six or seven months ago spots started to appear in his left eye. They started as smudges. Shape not as clear as the right eye, more like a large cloud. At first could only see through the edges of it, The cloud shrank and he could see though most of it, but it was very fuzzy and the image was distorted. there are other, smaller spots scattered around central focus.

Is this macular degeneration, or something else as well? Isn't it odd for someone so young to have this problem? Could it be related to a blood pressure which is high enough to cause concern? Many thanks for your reply.

[Ray T Oyakawa, MD]

This is probably hypertensive retinopathy with macular edema and loss of some of the small vessels in the macular area.  This is an medical emergency.   Please see an EyeMD (ophthalmologist) and an internist ASAP.

Dr. O.

[AntonReiser]

[As America is sleeping now let me try an answer.]
The problems are so severe that he at once needed a full medical exam by an internist and an ophthalmologist/ retinal specialist.
How long did he really have hypertension and how high was it? Is there also diabetes? Which other organs were also affected by a hypertensive crisis?
To me as a layperson the spots in the left eye seem to be vitreous hemorrhages which are not typical for AMD.
Please read:
http://en.wikipedia.org/wiki/Hypertensive_retinopathy

[Ray T Oyakawa, MD]

This is probably hypertensive retinopathy with macular edema and loss of some of the small vessels in the macular area.  This is an medical emergency.   Please see an EyeMD (ophthalmologist) and an internist ASAP.

Dr. O.

[allmymarbles]

Many, many thanks for your quick response. I have notified my friend and told him to seek immediate medical care.

[allmymarbles]

And many thanks to you. I am so afraid he will go blind.

[allmymarbles]

Doctor Oyakawa, how would someone without insurance handle this situation? Obviously he needs help.