Hypertensive Retinopathy

Key points

• • High blood pressure damages the small arteries of the retina, and the changes can be graded by how severe they are.
• • Early changes are a narrowing of the arteries and a nipping of the veins where the arteries cross over them.
• • More severe disease shows flame-shaped haemorrhages and cotton-wool spots from small blocked vessels.
• • The most severe grade shows swelling of the optic disc (papilloedema), a sign of dangerously high blood pressure.
• • The retinal changes mirror the damage happening in other organs, so the eye gives a window on the whole body.