DR. BARNITA DAS

DR. MODINI PANDHARPURAR

Abstract

We report a case of indirect carotico-cavernous fistula(CCF) Type-C. A 65 years old female presented with gradually progressive forward protrusion with redness and pain in right eye(RE) for 3 months along with occasional headache. Blood pressure of 150/100mmHg and vision of RE:CF-1/2metre and left eye(LE):CF-5metre were recorded with caput medusae in RE and mild congestion in LE. Hertel’s exophthalmometry values were RE:23mm and LE:19mm. Inferior scleral show and extra-ocular movements restriction in RE with intraocular pressure of 24mmHg were noted. No bruit was heard. Prominent right superior orbital vein in CT scan orbit and right-sided moderate flow indirect CCF in cerebral angiogram were reported. Antihypertensive and antiglaucoma medications with endovascular embolization of the feeder vessel showed satisfactory results. Being less symptomatic indirect CCFs may be missed in routine examination. We should be vigilant enough in managing these cases on time and save the vision.