A 54-year-old man presented with an acute painless loss of vision. He
had a three-month history of malaise, weight loss, and episodic sweati
ng. Physical examination showed a thin, febrile man with a petechial r
ash over the lower legs. Cardiac auscultation revealed an apical thril
l and pansystolic murmur. Dental hygiene was poor. The diagnosis, mech
anisms and treatment of retinal artery occlusion associated with bacte
rial endocarditis are reviewed.