Purpose: To report a case of central retinal artery occlusion with ophthalmoplegia. Method: Case report. Result: A 59-year-old woman woke up with left eye blindness. A history of persisting eyeball compression during sleeping was likely due to overdose of sleeping pills. Her visual acuity was light perception. Swelling of the left cheek, left hypertropia, relative afferent pupillary defect, and retinal edema were noted. She received methylprednisolone pulse therapy. A pale disc developed 2 weeks later. Discussion: A combination of central retinal artery occlusion and ophthalmoplegia was reported after spinal surgery. Ophthalmic artery occlusion due to compression was the probable cause. The perfusion was restored when the patient’s position changed, but the ischemic damage was irreversible.