A series of 187 cases of retinal artery occlusion was reviewed. 107 of which were central retinal artery occlusions (CRAO). Of the 107 cases, 28 (26%) showed some degree of macular sparing owing to a patent cilioretinalartery. The patients with cilioretinal sparing regained variable degrees of visual acuity, depending on the amount of the pipillomacular bundle supplied by the patent vessel. The patients with CRAO without cilioretinal sparing rarely regained any useful vision. To our knowledge, this is the first large series documenting the degree of visual return in such cases. From this data, guidelines for counseling patients with CRAO with cilioretinal sparing are presented.