Editor,— Sildenafil is the oral treatment for erectile dysfunction and was licensed throughout Europe in September 1998. It is a potent, selective inhibiter of the isoenzyme phosphodiesterase type 5 (PDE 5). Inhibition of PDE5 leads to prolongation of cyclic guanosine monophosphate (cGMP) activity in erectile tissue and increases the natural vasodilatory actions of nitric oxide on the cavernosal smooth muscle, facilitating the erectile response in men with erectile dysfunction.1 Whereas many ocular adverse effect of sildenafil have been reported,2-5 we present, to the best of our knowledge, the first case report of branch central retinal artery occlusion following the use of sildenafil.