The picture of severe ocular ischemic syndrome (OIS) drew attention to and investigations (sonography and carotid angiography) showed extensive atherosclerotic damage of vessels on more levels by a 46 year old patient with ischemic oculopathy, venous stasis retinopathy and neurological difficulties. The successful desobliteration of a. carotis interna adjusted the neurological difficulties of the patient and stabilized visual functions.