DOI: 10.36347/sjmcr.2017.v05i10.010

Pages: 635-638

A 65 year-old Malaysian Chinese gentleman with history of hypertension presented with bilateral eye redness for three years associated with diplopia, mild blurring of vision, watery eyes, nausea and dizziness. On examination, the right eye best corrected visual acuity was 6/12 and left eye was 6/9. The right lateral gaze was slightly restricted and there was prominent corkscrew episcleral vessels on both eyes. CT Brain & Orbit showed mucosal thickening in left ethmoidal and left maxillary sinuses. CT angiogram showed bilateral symmetrical bulky and prominent cavernous sinuses with bilateral symmetrical enlarged and engorged superior ophthalmic veins. Bilateral carotid cavernous fistulas (CCFs) are extremely rare. Our case is the fourth (4th) case of bilateral spontaneous CCFs that has been reported so far to achieve spontaneous resolution of ophthalmologic symptoms without neurosurgical or vascular intervention.