To describe the clinical course of patients 55 years and younger with central retinal vein occlusion (CRVO).Design and Methods: Retrospective, noncomparative case series. Medical records of 67 patients were reviewed for demographic, photographic, clinical, and visual acuity (VA) data. Data from 57 patients with at least 6 months of follow-up (mean, 29.2 months) were analyzed statistically.Main Outcome Measures: Best-corrected visual acuity and incidence of intraocular neovascularization.Results: Of 67 consecutive patients (55% men; mean age, 45 years), the median presenting VA was 20/50. Fortyfive patients (67%) were found to have at least 1 systemic disease. In 57 patients with at least 6 months of followup, the final VA was 20/40 or better in 42%, 20/50 to 20/ 100 in 18%, and 20/200 or worse in 40%. Visual decline was most common within 3 to 6 months of CRVO onset. Visual improvement was uncommon after 12 months. Of CLINICAL SCIENCES