A Rare Case of Superior Ophthalmic Vein Thrombosis Due to Cryoglobulinemia

Superior ophthalmic vein thrombosis (SOVT) has many well-defined infectious, autoimmune, hematologic, and malignant etiologies. We present the first known case of SOVT associated with idiopathic cryoglobulinemia. A 42-year-old woman with a history of idiopathic cryoglobulinemia presented with severe headache, right eye pain, and diplopia. Imaging revealed retrobulbar inflammation and an engorged superior ophthalmic vein, consistent with SOVT. The patient was treated with heparin and intravenous methylprednisolone, resulting in significant clinical improvement. Cryoglobulinemia is a small to medium vessel vasculitis caused by immune complex precipitates; it is typically associated with conditions such as hepatitis C and hematologic disorders, but idiopathic cases are also recognized. We report SOVT as an unusual manifestation of cryoglobulinemia, emphasizing the importance of considering SOVT in the differential diagnosis of patients presenting with cryoglobulinemia and eye pain.