- A 40-year-old man presented with a 5-week history of headaches and blurred vision in both eyes, with no other medical history. He reported having no chest pain or shortness of breath. A physical examination was notable for a blood pressure of 210/130, and the visual acuity was 20/200 in both eyes. Fundus examination revealed optic-disk hyperemia and blurring (long arrow), retinal hemorrhage (short arrow), a macular “star” with lipid deposits (arrowhead), and venous congestion, in both the right eye (Panel A) and the left eye (Panel B). The patient was admitted to the hospital and given urgent care. Urinalysis revealed . . .