Systemic hypertension is a highly prevalent clinical condition encountered in optometric practice on a daily basis. Hypertension produces, both directly and indirectly, a variety of ocular manifestations for which the patient may seek optometric care, or which may be detected by the optometrist during the course of examination. Determination of the patient's blood pressure status through thorough history taking and patient examination, including in-office sphygmomanometry screening, offers a tremendous opportunity for holistic optometric care that has a positive impact on patient longevity and quality of life. This review of hypertensive fundus changes provides an in-depth historical perspective of the ocular manifestations of systemic hypertension, the current clinical and basic research thinking on the pathophysiology of observed hypertensive ocular changes and its appropriate documentation, and the clinical application of this important information in the primary care optometric setting.
