The cases of 52 consecutive persons with ocular ischemic syndrome (ocular symptoms and signs attributable to severe carotid artery obstruction) were studied. Followup disclosed a five year mortality of 40%. In comparison, an age and sex matched control group from the Framingham study had a five year mortality of 11%. The leading cause of death was cardiac disease (63%), while stroke was second (19%). Other associated diseases included systemic arterial hypertension (73%), diabetes mellitus (56%) and peripheral vascular disease (19%).