Mixed retinal vascular occlusions are rare conditions associated with poor visual prognosis. We describe a patient pre- senting a sequential arterial and venous occlusion, leading to ischemic ocular syndrome. History and Signs A 60-year-old diabetic male patient developed unilateral visual loss (CF). Fundus exami- nation revealed a central retinal artery occlusion. After 2 months, he presented a painful eye. Biomicroscopy revealed anterior seg- ment neovascularization, and IOP was 10mmHg. Fundus exami- nation revealed moderate signs of a central retinal vein occlusion. Panretinal photocoagulation was applied. After 4 days, as pain was still present, with mild anterior segment uveitis and normal IOP, an anterior segment fluorescein angiogram was performed, revealing sectorial iris non-perfusion. Therapy and Outcome General examination revealed a severe carotid obstruction. As a previous contralateral endarteriectomy had been complicated leading to a vascular prosthesis, further ipsilateral carotid surgery was not advised. Panretinal photocoagulation led to the abolition of pain and neovascularization. Conclusions This case illustrates the con- tinuum of retinal arterial and venous occlusion with the rare com- plication of an ischemic ocular syndrome.