Sickle cell disease (SCD), the most commonly inherited hemoglobinopathy, can result in vision loss due to sickle cell retinopathy (SCR), vascular occlusions, and retinal atrophy. SCR is more common in heterozygous (HbSc) than homozygous (HbSS) patients. HbD (Punjab) is a less commonly reported form of hemoglobin in SCD, seen in northwestern states of India. Patients with sickle cell hemoglobin D disease (HbSD) can clinically behave like HbSS. We report a case of asymmetric SCR and multiple branch retinal artery occlusions in a patient with sickle cell hemoglobin D disease in central India.