Numerous diseases that feature blood hyperviscosity similar to sickle cell disease can manifest as retinal venous tortuousity.[1] Tortuosity is caused by arteriovenous shunting from the retinal periphery.[6] It can feature small bleeds of the retina known as intra-retinal hemorrhages,[3] due to blockage of blood vessels by the sickled blood cells, thus triggering vessel wall necrosis.[5] The resulting hemorrhages are initially bright red and oval shaped.