Background: To evaluate the role of dyslipidemia on fundus changes in hypertensive patients,and to correlate above findings with the components of lipid profile (LDL, HDL, VLDL, Total cholesterol and triglycerides). Method: One hundred consecutive subjects who attended ophthalmology OPD and inpatients of A.J Institute of Medical Sciences Mangalore who were diagnosed with primary essential hypertension were enrolled in this prospective study. All the subjects (200 eyes) were subjected to a detailed ophthalmic examination. Fundus changes were classified according to Keith, Wagener and Barker (KWB), and Modified Scheie’s grading system. Investigations in this study include Complete blood count (Hb, TLC, DLC, ESR), Urine routine and microscopic examination, random blood sugar, fasting serum lipid profile. Other investigations like blood urea, serum creatinine, Chest X-ray, ECG, ECHO, CT scan were done based on clinical diagnosis and suspicion of end organ dysfunctions. Data were collected using apre-structured proforma and analysed using SPSS 13.0 Results: Out of the 100 patients with essential hypertension, 75(75%) had retinopathy and the remaining 25(25%) subjects had no retinopathy. Severity of hypertension correlated well with severity of retinopathy (p<0.008). No sex preponderance towards developing retinopathy was found in this study (p<0.544). Our study showed significant relationship between various grades of retinopathy and duration of hypertension (p<0.000). A positive correlation of hypertensive retinopathy was found with total cholesterol value (p<0.013), serum triglycerides (p<0.039) and cholesterol:high-density lipoprotein (cholesterol:HDL) ratio (p<0.015). Conclusion: This study proved a definite association between serum lipid parameters and the prevalence of hypertensive retinopathy (HR)
