A 37-year-old man had bilateral decreased vision and metamorphopsia. His medical history was significant for anaplastic astrocytoma of the brain diagnosed 13 years earlier, for which he had undergone surgical resection, radiation, and chemotherapy. He had been receiving high-dose tamoxifen citrate (200 mg/d) for the previous 12 years, resulting in a cumulative dose of 876 g. At his initial visit, Snellen visual acuities were 20/60 OD and 20/80 OS. Anterior segment examination findings were unremarkable, without corneal or lenticular opacities. Funduscopic examination revealed extensive bilateral, refractile, white perifoveal crystalline deposits (Figure, A and B). Similar refractile deposits were observed in the retinal periphery extending to the ora serrata. Severe CME was noted with bilateral honeycomb-like cystic spaces displaying significant late leakage on fluorescein angiography. Optical coherence tomography demonstrated central macular thicknesses of 764 μm OD and 818 μm OS and also confirmed the presence of crystals within the inner retina (Figure, C and D).