Hypertensive retinopathy: The need for a change in perspective

In view of the growing global presence of what is already the leading contributor to death and disability on the planet - systemic hypertension - we need to better suspect, recognize, and interpret hypertensive retinopathy in the context of systemic implications and multiple organ damage. Hypertension itself is grossly underdiagnosed and undertreated, calling for the ophthalmologist's discretion to proactively suspect systemic hypertension in both young and older adults, separate acute from chronic retinal changes, pick up the subtle clues of choroidopathy, and appreciate the implications of disc edema in systemic hypertension. Far from acting as a mere referee, we need to guide and direct the urgency and nature of systemic management by the physicians and relevant sub-specialists.