# A case of permanent vision loss due to a carotidcavernous fistula: importance of early diagnosis

## TL;DR

A 97-year-old woman experienced permanent vision loss from a carotid-cavernous fistula due to delayed diagnosis despite early symptoms.

## Contribution

Highlights the importance of early clinical suspicion for carotid-cavernous fistula in patients with palpebral hyperemia and edema.

## Key findings

- Delayed diagnosis of carotid-cavernous fistula led to irreversible vision loss despite embolization.
- Initial symptoms like palpebral hyperemia and edema can indicate carotid-cavernous fistula.
- Early detection is critical to prevent permanent visual damage.

## Abstract

A 97-year-old female presented with spontaneous acute-onset palpebral hyperemia
and edema of the right eye that had progressively worsen over the previous three
days. These signs did not suggest possible carotid-cavernous fistula until a
second examination 72 h later, during which the patient exhibited significant
progression. Despite embolization, the patient exhibited sustained corneal
edema, clots, and turbidity in the aqueous humor, which resulted in permanent
visual loss. A greater level of clinical suspicion for possible
carotid-cavernous fistula is warranted on initial presentation of palpebral
hyperemia and edema to prevent possible irreversible vision loss.