A case is presented of a 24-year-old woman with acute, painless visual loss that occurred after sneezing. The patient had no previous ocular disease history. Ophthalmic work-up revealed a cilioretinal artery occlusion in the right eye. Transesophageal echocardiography showed a secundum atrial septal defect with right-to-left shunt. Sudden visual loss requires thorough investigation to determine the cause. In this case, examination revealed a retinal artery occlusion, whose risk factors include older age, systemic hypertension, diabetes mellitus, atherosclerosis, and giant cell arteritis (temporal) in more than 75% of patients. Especially in patients younger than 40 years, an embolus of cardiac origin (atrial septal defect, patent foramen ovale, or valvular) should be suspected as a cause of retinal artery occlusion.
[Ophthalmic Surg Lasers Imaging Retina. 2014;45:e30–e31.]
From the departments of Emergency Medicine (EO, AAC, NA, SD, DK), Neurology (OO), and Ophthalmology (AO), Eskisehir Osmangazi University Medical Center, Eskisehir, Turkey; and Medical College and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates (AAC).
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Engin Özakin, MD, Eskisehir Osmangazi University Medical Center, Department of Emergency Medicine, Meselik, 26480, Eskisehir, Turkey; +90 222 2256129; fax: +90-222-2393774; email:
Received: December 22, 2013
Accepted: February 11, 2014
Posted Online: July 24, 2014