Ophthalmic artery occlusion due to cocaine-induced carotid artery dissection: A case report

A 35-year-old male with a history of chronic substance use presented with a history of pulsatile headache, followed by right-eye amaurosis. He reported cocaine use the day before symptom onset. Ophthalmologic examination revealed no light perception in the right eye and a right afferent pupillary defect, and fundoscopic examination revealed diffuse retinal pallor and generalized vascular attenuation, suggestive of retinal and choroidal ischemia. Imaging studies confirmed complete dissection of the internal carotid artery and absent flow in the ophthalmic artery. After a thorough examination and the exclusion of embolic and autoimmune causes, it was concluded that the patient had an ophthalmic artery occlusion secondary to a cocaine-induced internal carotid artery dissection.