A 15-year-old adolescent girl with idiopathic intracranial hypertension was noted to have papilledema and optociliary shunt vessels. Medical management was controlling her symptoms, but vision deteriorated rapidly in the left eye secondary to a vitreous hemorrhage. Given the lack of any other cause for vitreous hemorrhage, it most likely originated from the shunt vessels. Optic nerve sheath fenestration was performed in an effort to promote regression of the papilledema and the shunt vessels. Our case illustrates a rare complication of optociliary shunt vessels in the setting of papilledema.