Copper-Wiring and Silver-Wiring

  • Thickening of walls of retinal arterioles from chronic hypertension
  • Retinal arterioles appear orange or yellow instead of red ("copper wiring")
  • Retinal arterioles look white if they have become occluded ("silver wiring")
  • Retinal arterioles indent retinal veins as they cross each other ("arteriovenous nicking")
  • Nothing—your challenge is to recognize this sign!
  • Recognize these signs of chronically elevated blood pressure
  • Measure blood pressure, but even if not currently elevated, assume it has been elevated in past
  • Make sure blood pressure is controlled
  • Poor blood pressure control has adverse consequences—heart attack, stroke, and kidney disease among them