At age 38 this patient developed blurred vision in his left eye and was diagnosed with nonischemic central retinal vein occlusion. On follow-up 3 years later he was found to have engorged vessels in the left eye and blood in Schlemm’s canal. The intraocular pressure in this eye was elevated at 28 mmHg compared to 10 mmHg in the fellow eye. An ultrasound examination of the orbit revealed no reverse blood flow. No etiology for the elevated episcleral venous pressure was ever found.