PURPOSE: To report a 34-year-old healthy man with an internal carotid artery dissection who presented with an ipsilateral branch retinal artery occlusion. METHOD: Case report. RESULTS: Ophthalmic examination of a young adult presenting with transient monocular visual loss and a superior nasal field defect disclosed a left inferior branch retinal artery occlusion. After fluorescein angiography, the patient had a vasovagal response, and his condition worsened to a left central retinal artery occlusion. Neurologic evaluation followed by carotid angiography disclosed a left internal carotid artery dissection with total occlusion of the internal carotid artery. CONCLUSION: The differential diagnosis of retinal arterial occlusion in a young healthy adult without any notable ocular or medical history, including trauma, should include spontaneous internal carotid artery dissection.
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