DR. SAKSHI SINGH

Abstract

An old male presented with complaint of painless progressive diminution of vision in LE since 2 years. He had been operated for cataract in both eyes. He negated for any redness of eyes, fever or trauma, diabetes or hypertension.

On examination, vision in RE was 6/6 while in affected LE was hand movement. IOP was 16mmHg in BE. The pupil was small & sluggish reacting in RE while it was normal in size but sluggish reacting in LE. There was no neovascularisation of iris or angle in any eye. The patient was pseudophakic in BE. On dilated fundoscopy the RE was unremarkable but LE showed few cotton-wool spots along with neovascularisation of disc along with few dot-blot haemorrhages around the macula & also temporal to fovea and attenuation of arteries. Carotid doppler suggested thrombosed Left ICA with absent flow along with atherosclerotic changes at bilateral carotid bulb.

After vascular and neurosurgery opinion, carotid end-arterectomy was suggested for which the patient did not consent.