Amaurosis fugax induced by carotid body tumor

A 60 year-old Romanian female with a one-year history of 10-20 minute episodes of painless visual loss OS, accompanied by a droopy eyelid OS. Review of systems revealed a five year history of hoarseness, intermittent face and neck tightness and dyspnea. PMH: HTN, CHF, hypothyroidism, emphysema, and adrenelectomy for pheochromocytoma. Family history of pheochromocytoma in four members. Visual acuity ( hyperopic correction) was 20/50 OD, 20/100 OS. She had bilateral neck masses, larger on the left, 2 mm ptosis OS, 2.5 mm nonreactive pupil OD, and 3 mm trace reactive pupil OS. She was on pilocarpine 2% and timolol/brimonidine OU. Anterior chambers were shallow with a patent iridotomy OS, and nuclear cataracts OU. Intraocular pressures were 15 OD, 16 OS. The cup/disc ratio was 0.4 OD, 0.8 OS. Threshold perimetry was constricted. Work up for transient visual loss was initiated.