LAUSR

BACKGROUND We describe a patient who developed delayed blindness of the left eye five weeks after endovascular coiling of a large ophthalmic aneurysm. CASE DESCRIPTION A 44-year-old male was admitted with visual decline due to compression of the optic nerve by a large ophthalmic aneurysm. The aneurysm was treated by endovascular coiling, but visual function was unchanged. One month and seven days later, the patient developed sudden blindness of the affected eye, despite complete angiographical occlusion of the aneurysm. Surgical exploration, in an attempt to restore vision, showed a fully thrombosed aneurysm but, surprisingly, complete transection of the optic nerve just proximal to its entry into the optic canal. CONCLUSIONS This report describes a rare complication of a sudden increase in size of large ophthalmic aneurysms, despite successful endovascular occlusion.