This report presents the case of a man aged 45 years who came into the emergency department with acutely worsening vision during the course of 1 week. He was found to have acutely worsening nephrotic syndrome secondary to focal segmental glomerulosclerosis despite systemic immunosuppression. His ophthalmic examination revealed large nerve fiber layer hemorrhages in the posterior pole, significant macular edema, and areas of polygonal retinal whitening sparing the blood vessels, consistent with a diagnosis of Purtscher-like retinopathy. The patient was started on intravenous methylprednisolone followed by an oral taper of prednisone with improvement in his visual acuity and clinical findings 2 weeks later. [Ophthalmic Surg Lasers Imaging Retina 2022; 53:393-396.].