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. 2005 Dec;89(12):1646–1654. doi: 10.1136/bjo.2005.072546

Table 2.

 The Keith, Wagener, and Barker117 hypertensive retinopathy classification (grade I–IV), based on the level of severity of the retinal findings

Grade Classification Symptoms
Grade I (mild hypertension) Mild generalised retinal arteriolar narrowing or sclerosis No symptoms
Grade II (more marked hypertension retinopathy) Definite focal narrowing and arteriovenous crossings. Moderate to marked sclerosis of the retinal arterioles. Exaggerated arterial light reflex Asymptomatic
Grade III (mild angiospastic retinopathy) Retinal haemorrhages, exudates and cotton wool spots. Sclerosis and spastic lesions of retinal arterioles Symptomatic
Grade IV Severe grade III and papilloedema Reduced survival