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[Case Report Comment] Putting raised intraocular pressure in context

In The Lancet, Miles Kiernan and colleagues1 report an unusual case of a patient who developed sight-threatening ophthalmic problems after upper arm surgery. The ipsilateral symptoms and signs in this case (red eye, proptosis, limited eye movements, raised intraocular pressure, and retinal haemorrhages) are all classic presenting features of orbital venous hypertension. The most common cause is an arteriovenous fistula in the cavernous sinus and ophthalmologists are well aware of the need to investigate this possibility in any patient presenting with a unilateral red eye and raised intraocular pressure.