A patient with a right proptosis caused by caroticocavernous
Arterialization of the episcleral vessels caused by
Caroticocavernous fistula typically causes unilateral proptosis with a red eye. However, no all proptosed eye with redness
are caused by carotid cavernous fistula. The signs to look for in CCF are pulsation and arterialization of the episcleral
vessels. Otherwise, conditions like thyroid eye disease, pseudotumour and cavernous haemangioma can also give rise to
proptosis with engorged vessels (but no arterialization)
There is unilateral proptosis with arterialization of the episcleral vessels. The globe is pulsating on close observation. Bruit can be hear over the orbit (best with the bell of the stethoscope). In severe cases, there may be ophthalmoplegia due to orbital
Mention you would like to examine:
- the intraocular pressure
- the anterior segment and posterior segment for signs of ischaemia (anterior uveitis, rubeosis iridis, cotton wool spots etc).
1. What are the different types of caroticocavernous fistula?