Unilateral choroidal effusion secondary to carotid cavernous fistula.

A man in his mid-70s presented to the eye clinic with sudden onset ptosis, bilateral ophthalmoplegia associated with eye pain and sluggish pupillary reaction. MRI of the head revealed cavernous sinus thrombosis. He was treated with warfarin and a regime of steroids which improved his ophthalmoplegia.