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Malignant hypertension, which was defined as the association of a severe elevation of blood pressure with retinopathy stage III or IV according to KEITH and WAGENER, now takes into account the involvement of the noble organs such as central nervous system, heart and kidneys. It is this attack that determines the severity, urgency and vital prognosis of this pathology. Uncommon in children and teenagers, malignant hypertension often secondary, involving kidney in the most cases. It is a therapeutic emergency because it is at risk to progress into hypertensive encephalopathy, stroke, acute renal failure, or heart failure, all of which represent its usual pattern of discovery. We report the case of malignant hypertension in a teenager without personal pass history of hypertension. The singularity of this report case is the uncommon mode of his discovery: isolated bilateral visual impairment. This clinical case challenges us and reminds the interest of the funduscopic examination during ophthalmological consultation, and teaches us that taking the blood pressure of a teenager who consults for an isolated bilateral decrease of vision is not without interest. Early recognition and management of malignant hypertension, are fundamental to any improvement in prognosis of this serious disease.

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