Snap Shot A 65-year-old man with polycythemia rubra vera presents with sudden onset, painless, vision loss. On retinal exam, widespread retinal hemorrhages are noted. Introduction Sudden complete, painless loss of vision in one eye as a result of retinal venous occlusion Risk factors hypercoagulability/hyperviscosity (e.g polycythemia rubra vera) diabetes mellitus glaucoma hypertension Presentation Symptoms painless vision loss Physical exam swelling of the optic disc venous dilation widespread retinal hemorrhage cotton wool exudates Treatment No definitive treatment Prognosis, Prevention, and Complications May resolve spontaneously or progress to permanent vision loss