The changes in the fundus of the eye which accompany arterial hypertension present two distinct pictures: (1) that due to slowly progressive changes in the retinal arteries, and without any abnormal contraction or narrowing of these arteries; (2) that in which there is seen an abnormal narrowing of the retinal arteries with secondary changes in the substance of the retina, and which constitutes arteriospastic retinopathy.
In the first picture there are seen (1) an irregular tortuosity of the retinal arteries; (2) a widening of the light reflex; (3) a hiding of a portion of the vein on each side of the artery which crosses it; (4) irregularities in the course of the arteries, and (5) occasionally, arteries which have a copperwire or silver-wire appearance.
These elements are apt to vary considerably from a mild to a marked degree. They constitute the fundus picture seen in cases of benign essential hypertension.
ELWYN H. The Changes in the Fundus of the Eye in Arterial Hypertension. AMA Arch Ophthalmol. 1956;55(1):3-8. doi:10.1001/archopht.1956.00930030005002