This study presents three cases of so called Saturday night retinopathy, an acute visual loss following intravenous drug abuse and stupor, leading to continuous pressure on the orbit while asleep. All three cases presented with acute vision loss and had funduscopic evidence of ophthalmic or central retinal artery occlusion. Two of the cases also presented with ophthalmoplegia and proptosis. One of the cases had significantly increased intraocular pressure and corneal oedema. All three cases had poor visual outcomes with severe visual loss in the affected eye and no recovery. The authors detail the cases with photographs and imaging and discuss the possible causes for this finding. It is thought that prolonged periods of altered mental state inhibit spontaneous movement, which would normally alleviate the focal compression during normal sleep. Unfortunately no treatment has proven to be of any benefit.