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Letter to the Editor
Spontaneous dissection of internal carotid artery presenting as isolated posterior ischaemic optic neuropathy
  1. RONG-KUNG TSAI,
  2. CHUN-YIH SUN
  1. Department of Ophthalmology, School of Medicine, Kaohsiung Medical College, Kaohsiung, Taiwan
  1. Rong-Kung Tsai, MD, Department of Ophthalmology, School of Medicine, Kaohsiung Medical College, 100 Su-Chuen 1st Road, 807 Kaohsiung, Taiwan.

https://doi.org/10.1136/bjo.81.6.513

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    Editor—Posterior ischaemic optic neuropathy (PION), which is a diagnosis of exclusion, has been associated with a variety of vascular diseases such as giant cell arteritis, systemic lupus erythematosus, atherosclerosis, polyarteritis nodosa, hypotension, and rarely acute occlusion of the internal carotid artery.1 We present a patient with monocular PION resulting from ipsilateral internal carotid artery dissection.

    CASE REPORT

    A 55-year-old man presented to our neuro-ophthalmology unit with blindness in the right eye, which he had noticed on awakening 3 days ago. His past medical history showed a 5 year history of hypertension and 3 year history of diabetes mellitus with poor control. He had a 1 month history of right frontal headache occasionally associated with blurred vision in the right eye. On examination, visual acuity was no light perception in the right eye, 20/20 in the left eye, and a right afferent pupillary defect was present. Extraocular motility was full in each eye. The slit-lamp examination was unremarkable. Dilated fundus examination showed a depigmentation patch in the pupillomacular bundle in the right eye, normal retinal vessels, and …

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