Cocaine is one of the most dangerous illicit drugs in use today,1 2 with growing reports of its abuse causing serious complications. We present an unusual case of a previously healthy young man with sudden bilateral visual loss caused by smoking “crack” cocaine.

Case report

A 24-year-old white man presented with a 1-week history of sudden bilateral reduced vision. He had been an intravenous heroin abuser but denied use during the last 7 months. He was on oral flucloxacillin (for an infected burn) and oral methadone (60 mg/day). No stigmata of intravenous drug use were found. Visual acuities were finger-counting bilaterally. The anterior segments were normal with …