A 61-year-old female patient with treatment-resistant, end-stage mantle cell lymphoma and progressive central nervous system involvement with diffuse leptomeningeal lymphomatosis presented with sudden vision loss in the right eye for 2 weeks. On examination, visual acuity was no light perception OD. Fundus examination revealed severe, infiltrative optic neuropathy; ophthalmic artery occlusion with a cherry-red spot and macular edema; central retinal vein occlusion with dilated, cyanotic retinal veins and retinal hemorrhages in 4 quadrants; and preretinal, neoplastic vitreous seeding layering on a subhyaloid, preretinal, boat-shaped hemorrhage (Figure). Mantle cell lymphoma has a high recurrence rate and poor prognosis, with median survival ranging from 3 to 5 years from presentation.1 The ocular adnexal manifestations of mantle cell lymphoma have been described, but intraocular involvement is exceedingly rare.2 The patient’s retinal vascular compression resulted from an infiltrative neoplastic mass effect. Unfortunately, the patient died 3 weeks after presentation.