An asymptomatic 56 year old caucasian woman was referred when her optometrist noted an area of ‘hyperaemia’ in the centre of her right optic disc at a routine visit. On presentation, her visual acuities were 6/9 in each eye, with normal intraocular pressures. Fundoscopy revealed a right optic disc macroaneurysm. 9 months later, the visual acuity of the right eye suddenly deteriorated to 6/60 and an inferior altitudinal field defect was demonstrated. Fundal examination revealed an area of haemorrhage overlying the aneurysm and a superior branch retinal artery occlusion. Spontaneous rupture of the aneurysm involving the proximal part of the superior branch of the central retinal artery was thought to have led to secondary closure of the distal vasculature. Examination 3 months later revealed complete resolution of the aneurysm and visual acuity had improved to 6/12.
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