An 86-year-old male with nephrotic syndrome, diabetes, and hypertension presented with sudden, painless left eye vision loss. Examination revealed left nasal field loss with preserved temporal vision. Ophthalmology confirmed CRAO. Brain MRI identified acute left basal ganglia and right cerebellar lacunar infarcts. Six days into admission, the patient developed RVM, with transient episodes of upside-down vision and right eye diplopia, without other new deficits. Imaging showed no new infarcts. Visual disturbances resolved spontaneously. Workup revealed a mitral valve lesion suggestive of non-infective endocarditis, with negative blood cultures and elevated inflammatory markers. The patient was managed with dual antiplatelet therapy and transitioned to anticoagulation and antibiotics.