Abstract
Central retinal artery occlusion (CRAO) is a multifactorial disease, where inflammation and hypercoagulability are the major risk factors. It is a rare occurrence in this geographical area in patients diagnosed with sinus mucormycosis infection, which has emerged as one of the most fulminant, opportunistic secondary infection during post-COVID era. We report a case of a bilateral CRAO, in a 66-year-old, post-COVID, diabetic patient. A complete eye examination followed by radiological imaging of brain, orbit, and paranasal sinuses were done. Multidisciplinary approach was contemplated to reach a diagnosis of bilateral rhino-orbital-cerebral mucormycosis (ROCM). Intravenous liposomal amphotericin-B injection was started as a part of systemic management and an aggressive sinus debridement of both sides with amphotericin-B wash was also done. Despite an early diagnosis and intervention, the patient succumbed to her illness. All post-COVID patients presenting with the complaints of blurring of vision should be meticulously examined for the presence of any retinal abnormality in both the eyes as this may be a manifestation of an underlying secondary fungal infection. Early diagnosis of ROCM and management will help in reducing complications.
Highlights
It has been reported that about 10-30% of secondary infections occur in severely ill, hospitalized, COVID patients
We report a case of a bilateral Central retinal artery occlusion (CRAO), in a 66year-old, post-COVID, diabetic patient
Multidisciplinary approach was contemplated to reach a diagnosis of bilateral rhino-orbital-cerebral mucormycosis (ROCM)
Summary
It has been reported that about 10-30% of secondary infections occur in severely ill, hospitalized, COVID patients. A 66-year-old lady, only two days of her discharge from post-COVID ward, consulted the department of ophthalmology with complains of sudden painless loss of vision in her both eyes with drooping of upper eyelid in the right side On presentation, she was conscious and afebrile but appeared disoriented. On the first post-operative day, she was responding to verbal commands, her eye condition still reported complete external ophthalmoplegia with a nonreacting pupil of both eyes indicating a cavernous sinus involvement in brain. Her visual perception showed no further improvement. There was a sudden fall in blood pressure, followed by cardiac arrest and she could not be resuscitated despite all efforts
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