A 55-year-old woman with no visual symptoms visited our medical center with an 8-mm left middle cerebral artery aneurysm. The neurosurgical team performed surgical clipping of the aneurysm and intracranial irrigation with 3 mL of papaverine hydrochloride (30 mg/mL) to prevent postoperative vasospasm. The middle cerebral artery was accessed via a transfrontal approach whereby the neurosurgical team created a small keyhole in the sphenoid bone. The following day, the patient's visual acuity was no light perception, she had proptosis, and she had a frozen globe. Fundus examination results were initially unremarkable. Orbital computed tomography revealed left orbital swelling. Two days postoperatively her proptosis resolved spontaneously, although her visual acuity remained no light perception. When stable 1 week postoperatively, fundus photography of her left eye revealed arteriolar narrowing and diffuse areas of retinal pigment epithelial hyperpigmentation and atrophy, which was more pronounced in the macula (Figure 1). Fluorescein angiography revealed delayed retinal filling and areas of hyperfluorescence and hypofluorescence that correlated with the findings seen on color photography (Figure 2). Her visual acuity loss and fundus findings were attributed to choroidal infarction that occurred immediately postoperatively. A cerebral internal carotid artery angiogram performed 4 days postoperatively, once her proptosis resolved, revealed a surgical clip at the expected location and no evidence of a clip or obstruction at the level of the ophthalmic artery, suggesting choroidal reperfusion. Her visual acuity remained no light perception.