A case is presented of a 24-year-old woman with acute, painless visual loss that occurred after sneezing. The patient had no previous ocular disease history. Ophthalmic work-up revealed a cilioretinal artery occlusion in the right eye. Transesophageal echocardiography showed a secundum atrial septal defect with right-to-left shunt. Sudden visual loss requires thorough investigation to determine the cause. In this case, examination revealed a retinal artery occlusion, whose risk factors include older age, systemic hypertension, diabetes mellitus, atherosclerosis, and giant cell arteritis (temporal) in more than 75% of patients. Especially in patients younger than 40 years, an embolus of cardiac origin (atrial septal defect, patent foramen ovale, or valvular) should be suspected as a cause of retinal artery occlusion.
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