PURPOSE: To report a case of bilateral central retinal vein occlusion as the 
presenting feature of new onset multiple myeloma in an otherwise healthy man.
METHODS: A 44-year-old man presented with painless visual changes in his left 
eye. Ophthalmic examination revealed what appeared to be bilateral central 
retinal vein occlusion and hematologic assessment resulted in the diagnosis of 
immunoglobulin G multiple myeloma.
RESULTS: Initial management was plasma exchange followed by a chemotherapy 
regimen of cyclophosphamide, bortezomib, and dexamethasone, and subsequent plans 
for bone marrow transplant.
CONCLUSION: Hyperviscosity syndrome seems similar to central retinal vein 
occlusion and may be associated with systemic conditions such as diabetes and 
atherosclerosis; however, alternative etiologies should be considered in young 
otherwise healthy individuals. This case underscores the need for diligent and 
thorough investigations for less common systemic conditions associated with 
retinal vein occlusions by primary care ophthalmologists.