Retinal lesions occur in 25 to 30% of patients with systemic lupus erythematosus (SLE). Visual loss, however, is rare. A patient who developed central retinal vein occlusion and blindness during the course of active SLE is described. The pertinent literature is reviewed with attention to possible pathophysiologic mechanisms.Several series have documented the occurrence of ocular disease in systemic lupus erythematosus (SLE) (1-3). Virtually any structure of the eye may be involved by an inflammatory process as evidenced by reports of conjunctivitis, episcleritis, uveitis, and retinitis (4). Moreover, these disorders can occur in the absence of hypertension, diabetes, uremia, or anti-malarial therFrom the