Co-existing Carotid-Cavernous Fistula and Central Retinal Vein Occlusion Presenting as Unilateral Vision Loss in a 30-Year-Old Male: A Case Report

Carotid-Cavernous Fistulas (CCFs) are aberrant arteriovenous connections between the carotid arteries and the cavernous sinus. Although uncommon, they might manifest with subtle or deceptive symptoms, especially in young individuals with no past medical history. This case study describes the clinical appearance, diagnosis, and treatment of a direct CCF in a 30-year-old male. The patient had a history of trauma three months prior to presentation followed by chief complaints of diminution of vision and swelling in the right eye. There was sudden increase in pain and swelling since 2 weeks prior to presentation. Patient underwent CT scan, ocular examination, fundus evaluation which revealed the presence of a direct carotid cavernous fistula along with Central Retinal Vein Occlusion (CRVO), following which surgical intervention was done. The patient had successful endovascular embolisation. Following surgery, ocular symptoms and proptosis along with visual acuity improved significantly. Early detection of CCFs is crucial for avoiding vision-threatening consequences. Clinicians should be cautious of young patients who have unexplained red eye, proptosis, as well as visual impairment, particularly after trauma. Prompt diagnosis using appropriate imaging and swift intervention can result in positive outcomes.