Fig. 11. Any combination of the hypertensive changes and arteriolar sclerosis may be seen in the fundus of a particular case, depending on the severity and duration of the hypertension. A. Grade IV hypertension with generalized and focal constriction, hemorrhages, exudates, and papilledema, and grade IV sclerosis with silver-wire arterioles. B. Grade IV hypertension and grade II arteriolar sclerosis compatible with a marked exacerbation of hypertension in a long-standing hypertensive patient. C. Grade II hypertension and grade IV arteriolar sclerosis compatible with controlled hypertension in a long-standing hypertensive patient. D. Grade IV hypertension and arteriolar sclerosis. (Scheie HG, Ashley BJ, Yanoff M: Medical ophthalmology: Hypertension and arteriosclerosis. In Scheie HG [ed]: Medical Ophthalmology: Ophthalmologic Manifestations of Systemic Diseases, pp 5, 8. Elgin, IL: Medicolor Illustration and Editorial Service, 1966)