This case-based lecture highlights visual and ocular signs and symptoms which lead to the diagnosis of heart-related abnormalities. Optometrists have the skill set to suspect and recognize potential cardiac and vascular issues if they take the time to listen to their patients, routinely monitor blood pressure and pulse, and carefully assess visual function and ocular health. Timely referral to the emergency department and/or cardiology can save vision, prevent stroke, and ultimately save a life.