A 60-year-old edentulous man with past medical history of hyperlipidemia, current smoker, and depression presented to the eye department with a 4-week history of progressive blurred vision. As per patient he saw a “white sheet” in front of his eyes worse in the right eye constantly. After his eye evaluation he was referred to the neurology clinic as he complained of having difficulty finding words to express him-self. He did report of having lost 10 lbs (4.5 kg) in weight during this period but no other complains such as fever, fatigue, sweating, chest pain, shortness of breath or any other neurological complains. There was no history of substance abuse including history of intravenous drug use. On general evaluation his Body Mass Index (BMI) was 26, had no clubbing or other skin manifestations such as splinter hemorrhages, petechiae (Osler nodes and Janeway lesions). He had no cardiac murmurs or extra heart sounds on auscultation. On abdominal examination there was no visceromegaly specially splenomegaly. His neurological examinations including his language were normal. His eye examination the fundus showed multiple, bilateral, white-centered retinal hemorrhages which were “Roth spots”.