Acute Visual Loss Secondary to Sneezing

A case is presented of a 24-year-old woman with acute, painless visual loss that oc- curred after sneezing. The patient had no previ- ous ocular disease history. Ophthalmic work-up revealed a cilioretinal artery occlusion in the right eye. Transesophageal echocardiography showed a secundum atrial septal defect with right-to-left shunt. Sudden visual loss requires thorough inves- tigation to determine the cause. In this case, exami- nation revealed a retinal artery occlusion, whose risk factors include older age, systemic hyperten- sion, diabetes mellitus, atherosclerosis, and giant cell arteritis (temporal) in more than 75% of pa- tients. Especially in patients younger than 40 years, an embolus of cardiac origin (atrial septal defect, patent foramen ovale, or valvular) should be sus- pected as a cause of retinal artery occlusion.