Hypertensive retinopathy is damage to the retina caused by high blood pressure. It is characterized by changes to the retinal blood vessels including arteriolar narrowing, arteriovenous nicking, hemorrhages, cotton wool spots, and in advanced cases, papilledema or macular edema. The risk and severity of retinopathy increases with higher or less controlled blood pressure levels. Treatment involves controlling the underlying hypertension through lifestyle changes and medication, with urgent referral needed for severe or malignant cases. Regular eye exams are important for monitoring hypertensive patients for signs of retinopathy.