Purpose: To report a case of bilateral ocular vascular occlusion with subsequent development of unilateral acute retinal necrosis in a patient with HIV infection. Methods: A single case was evaluated. Results: A 40-year-old woman presented with a sudden decrease in vision in the right eye for a 1-month duration. Disc pallor, arteriolar attenuation, and blot hemorrhages were seen in the midperiphery of the fundus of the right eye. On follow-up, the patient presented with reduced vision in the left eye for a 10-day duration. A fundus examination of the right eye showed extensive retinitis patches, and a cherry-red spot, boxcarring, and multiple sclerosed arterioles were seen in the left eye. The patient was later found to be positive for HIV infection but had never started therapy. Conclusions: A sequential progression from the occlusive event to retinitis should be kept in mind to customize follow-up for patients with HIV infection.
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