Intraocular hypertension caused by elevated episcleral venous pressure following arteriovenous fistula embolization

Increased intraocular pressure due to elevated episcleral venous pressure is a recognized complication associated with arteriovenous fistulas, which typically form between the carotid artery and the cavernous sinus. We report a case of a patient who developed paradoxical worsening syndrome a few days after he underwent a two-staged transarterial embolization procedure of a left sided ethmoidal arteriovenous fistula. The patient presented with signs of elevated episcleral venous pressure leading to intraocular hypertension caused by the iatrogenic partial obstruction of the left superior ophthalmic vein.