A chronic elevation of the episcleral venous pressure may occur after venous obstructive disease or arteriovenous fistulas in the orbit, head, neck, or mediastinum. Idiopathic and familial occurrences of elevated episcleral venous pressure have been reported. Association with an increased episcleral venous pressure is a rise in intraocular pressure which, if of sufficient magnitude and duration, may cause cupping of the optic nerve and visual field loss. A case of glaucoma with visual field loss secondary to elevated episcleral venous pressure is presented. Recognition of the etiology of such cases is important, since the management of these patients differs from that of patients having primary open-angle glaucoma.