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Do your blood vessels do the twist?


Ret and Ina were out for a leisurely stroll through the jungle (the back yard). Ret was looking at the twisty branches of the willow trees, when he noticed one was a bit off color. Just as he reached out to get a closer look, Ina shouted, “Stop! That branch slithered.”

For years it’s been known that twisty blood vessels in the skin, on the back of one’s leg, was a dreaded sign of aging. When seen in the eye, it’s also been a sign of high blood pressure.

For years when I saw these twisty ocular blood vessels, 90 percent of the time blood pressure was normal. I often wondered if what I was seeing might be a precursor to hypertension. As I pondered one day on this possibility, I remembered how the channels of fishing streams I visited over the years would change from year to year due to logs or boulders falling in. I also noted how the slower current correlated to a twisty stream and/or a stream over flowing its banks due to blockage downstream. I wondered if these same phenomena might also occur in blood vessels; and if so, what might cause it.

The vessel tortuosity is due to Atheromas , or pockets of cholesterol, that form in the vessel lining. This cholesterol accumulation not only breaks down tissue around it, making it more porous and brittle; but it also pushes out into the lumen, or open space, in the vessel.

Then as blood hits these “bumps” as it flows through the vessels, it’s diverted, causing the vessel to bend at each “bump.” Retinal changes are best seen with a retinal camera, long before they’re well viewed with an ophthalmoscope, even with dilation sometimes.

Recent studies are linking blood vessel tortuosity not only with hypertension but also diabetes, cholesterol irregularities, heart disease, glaucoma, macular degeneration, and other diseases both systemic and ocular. Another interesting item is that these correlations are not only showing up in adults, but also in children. In my own research I found that vessel tortuosity correlated to irregularities of cholesterol- about 55-60 percent in children and 85-90 percent in adults.

I often see edema (swelling) in the retina (back of eye) also. Since cholesterol has been found to be a precursor to many systemic diseases, I’ve found that vessel tortuosity, especially if found with retinal edema, can be a fairly accurate precursor to other diseases both in the eye and elsewhere.

The eye is the only place that blood vessels can be clearly seen in their natural state. Knowing this, annual eye exams not only make sure you see well but are also windows to your overall health and vitality.

Dr. Scott Borgholthaus is owner of Vision Haus Optometry in Cheney. He is a member of the Optometric Physicians of Washington and has been in private practice for over 27 years.

Dr. Borgholthaus would love to answer and/or include any questions or comments in future columns. Please send questions or comments to


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