Preeclampsia is a life-threatening disorder for both the mother and fetus. A 43-year-old woman presented with a 1-day history of bilateral decreased vision and no systemic complaints. Physical examination revealed an abdominal mass and further diagnostic testing revealed a previously unknown pregnancy. Admission resulted in an emergency cesarean section for fetal distress. This case provides a unique primer of the various diagnostic tests and their results in the diagnosis of preeclampsia. It also highlights the critical role ophthalmologists may play in the diagnosis of this potentially devastating disease.