An asymptomatic woman in her mid-40s was referred for an opinion regarding unusual fundus findings. Visual acuity was 20/20 OU. Fundus examination revealed tortuosity of the small and medium arterioles in both eyes, primarily in the macular region, without evidence of vascular occlusion, venous stasis, or ischemia on fluorescein angiography (Figure). Examination of the patient’s family members revealed similar vascular tortuosity, leading to a diagnosis of familial retinal arteriolar tortuosity.