Editor,—Central retinal vein occlusion (CRVO) is a condition which often has profound effects on vision. At present there is little to offer patients in the form of treatment to preserve vision. The visual outcome is largely determined by the severity and duration of the vein occlusion. Management is currently aimed at preventing the complications secondary to retinal ischaemia. The incidence of fellow eye involvement with CRVO is believed to be in the order of 1%. We present a patient with “second eye” CRVO, who presented with acute reduction in vision and who responded dramatically to intravenous streptokinase.