Superior Ophthalmic Vein in Dural Sinus Fistula
SJ is a 58-year-old woman who presented with intermittent diplopia over several months. She also mentioned that her eyes were always red with a mild aching sensation. She denied hearing her “pulse” at night while lying in bed. There was no history of trauma to her head. She had undergone radioactive iodine therapy for hyperthyroidism 10 years previously and her thyroid levels were maintained at normal levels by medication. Examination found vision in both eyes of 20/25 and intraocular pressures of 23 mm OD and 24 mm OS. Slit-lamp examination showed tortuous dilation of conjunctival vessels bilaterally. A stethoscope was applied to both globes through closed eyelids and no bruit was appreciated.