A timely slice saves the eye- Timely management of the sequelae of a spontaneously resolved carotico cavernous fistula

Carotico cavernous fistula (CCF) usually presents to the ophthalmologist in varying degrees from less severe episcleral congestion to very severe proptosis. Although the definitive management is the closure of the fistula, the secondary glaucoma and exposure keratopathy due to proptosis need to be managed by the ophthalmologist. In this case, the spontaneous closure of an indirect CCF has led to acute severe proptosis with impending compartment syndrome which was managed with lateral canthotomy and cantholysis. The combined treatment of cantholysis, tarsorrhaphy, anticoagulants, and anti-glaucoma medication saved the patient’s eye and restored his vision.