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 |