Visual changes or blindness, an unusual complication of hypertension during pregnancy, is a result of several mechanisms. The possible mechanisms, either central or peripheral, include retinal arteriolar vasospasm, thrombosis of the central retinal arteries, reversible cortical pathology, and retinal detachment [1]. Although retinal arteriolar vasospasm is the most common mechanism of visual disturbance, cortical blindness has an incidence of 1e15% in the setting of preeclampsia [2]. Retinal detachment, reported in 1e2% of patients with severe pre-eclampsia, is usually bilateral and serous, and its pathogenesis is often related to choroidal ischemia secondary to an intense arteriolar vasoconstriction [3e5]. The majority of patients have a complete recovery of vision with clinical management, and surgery is usually unnecessary [3e9]. Over the past 40 years, the incidence of visual problems has been declining, which probably reflects the lower incidence of severe pre-eclampsia due to better antenatal care. The following report is on a rare case of bilateral retinal detachment with subsequent blindness in a patient with severe pre-eclampsia, without the findings of arteriolar vasoconstriction, infarction, or cortical pathological changes. A 28-year-old nulliparous woman at 38 weeks of gestation presented to the emergency department due to an episode of syncope. On arrival, she complained of headache, pedal edema, and decreased urine output, with a higher blood pressure of 191/112 mmHg. Neurological examination was grossly normal and the confrontation visual fields were intact. An initial laboratory examination revealed 3þ proteinuria, a hemoglobin level of 146 mg/L, total white cell count of 14.9 10/L, platelet count of 106 10/L, alanine aminotransferase level of 11 IU/L, a creatinine level of 8.2 mg/L, fibrinogen level of 5.19 g/L, and FDP-D dimer level of