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A 32-year-old man with no significant medical history or recent trauma presented to
the emergency department with blurred vision, proptosis, redness, and pain of the
left eye, which had been increasing over the previous 2 weeks. The right eye was normal.
Physical examination of the left eye revealed injection, proptosis, afferent pupillary
defect, decreased visual acuity (OS 20/60, OD 20/20), increased intraocular pressure
(IOP) (OS 31 mm Hg, OD 13 mm Hg), and an audible bruit of the left eye (Figure 1). His neurologic examination was otherwise normal.
Figure 1Patient photograph of left eye showing injected conjunctivae and proptosis (arrow).
Carotid-cavernous and orbital arteriovenous fistulas: ocular features, diagnostic and hemodynamic considerations in relation to visual impairment and morbidity.
