A central retinal artery occlusion occurred in the left eye of a 25-year-old woman with migraine and bilateral intrapapillary drusen. An extensive investigation failed to establish the presence of any systemic disease or vasculopathy. Eight years later she had a central retinal artery occlusion in her right eye. Optic disk drusen and migraine may have combined to produce this patient's bilateral visual loss consequent to retinal vaso-occlusion.