|Year : 1967 | Volume
| Issue : 2 | Page : 71-72
Multiple emboli in central retinal artery following cavernous sinus thrombosis
KS Mehra, PN Somani
College of Medical Sciences, Varanasi, India
|Date of Web Publication||18-Jan-2008|
K S Mehra
College of Medical Sciences, Varanasi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mehra K S, Somani P N. Multiple emboli in central retinal artery following cavernous sinus thrombosis. Indian J Ophthalmol 1967;15:71-2
| Case Report|| |
A man aged 62 years, attended the emergency department of the S.S. Hospital, Banaras on 11-2-1964, with the history of severe headache and swelling of the right eye of four days duration. A week back the patient had developed an abscess in the right nostril and other furuncles in the region of the nose. For the last four days the patient was having severe throbbing type of headache with vomiting and swelling of the right eye, which went on increasing, with the result that the right eye ball was completely closed by the swollen lids. Patient had developed some swelling of the left eye as well since one day. The patient's vision in both eyes was reported normal before the illness.
In the general examination all the systems of the body were found normal. Marked swelling was present on the right half of the face specially over the lids and nose. Three small furuncles were present on the wall of the nose and one furuncle was present in the right nostril. Slight oedema was also present on the lids of the left eye.
Local Examination of the Eyes
Right Eye:-Marked oedema of lids was present. The eyeball was completely covered. There was irreducible proptosis, the movements of the eye were absent in all the directions and there was chemosis of bulbar and palpebral conjunctiva. Pupil was normal in size but sluggish in reaction.
Neither vision nor fundus examination could be done due to presence of oedema. Tension was normal. Left:-Oedema of lids was present. Movements of the eyeball were restricted. Pupil was normal in size and reaction to light. Fundus and vision were not examined.
Temperature-101˚F, B.P. 120/80, pulse 100 per minute, Total W.B.C.15,000 per c.mm. polymorphs 82, Lymphocytes 16, Eosinophils 2; V.D. R.L. negative; urine normal; X-Ray of skull-mucosal thickening of right maxillary antrum and right frontal sinus appeared dull; nothing abnormal in the orbits.
Patient was given heparin, dindivan,* penicilin G. crystaline and streptomycin systemically. The condition started improving. The patient was able to open the eyes and could also move both the eyes, but complained of complete loss of vision in the right eye. The right eye had only perception of light. Left eye vision was 6/9. Fundus findings were as follows:
General look of the fundus was quite pale. Disc was pale, margins well defined. Narrowing of the arteries was present. Blood columns were interrupted at places in the branches of the central retinal artery (box car effect) and small white spots were present in the arterial branches in all the quadrants. Pale yellow spots were present in the fundus all throughout. Small haemorrhages were present near the disc along the course of the arteries. Oedema was present in the macular area. Fundus of the left eye showed arteriosclerotic retinopathy of grade one. Fundus examination revealed that the patient had developed occlusion of the central retinal artery in the right eye as a result of multiple embolisms.
General condition of the patient improved with the treatment, but the vision did not improve inspite of giving vaso-dilators, retrobulbar injections and diamox. In the follow up it was seen that the patient had developed complete optic atrophy of the right eye with complete obliteration of the central artery and its branches.
| Summary|| |
A case of occlusion of central retinal artery due to multiple emboli, as a sequela of cavernous sinus thrombosis has been presented.