Serras-Pereira, RHipólito-Fernandes, DAzevedo, LVieira, L2022-04-292022-04-292020BMJ Case Rep. 2020 Sep 2;13(9):e235763.http://hdl.handle.net/10400.17/4053Central retinal artery occlusion (CRAO) is a rare but blinding disorder. We present a case of a 81-year-old woman with multiple cardiovascular comorbidities admitted to the emergency department due to sudden, painless vision loss on left eye (oculus sinister (OS)) on awakening. The patient also reported long standing fatigue associated with effort that started 4 months before admission. She presented best corrected visual acuity of counting fingers OS. Funduscopy OS revealed macular oedema with cherry red spot pattern. Blood cultures came positive for Streptococcus gallolyticus in the context of a bacteremia and native mitral valve vegetation identified on transoesophageal echocardiography. CRAO of embolic origin was admitted in the context of an infective endocarditis. CRAO can be the first manifestation of a potentially fatal systemic condition and thus multidisciplinary approach is warranted with close collaboration between ophthalmologists and internists in order to provide proper management and the best possible treatment.engCHLC OFTCHLC MEDAged, 80 and overFemaleHumansAcetazolamide / administration & dosageAdministration, IntravenousAdministration, OphthalmicAdministration, OralAnti-Bacterial Agents / administration & dosageAntihypertensive Agents / administration & dosageCeftriaxone / administration & dosageEchocardiographyEndocarditis, Bacterial / complicationsEndocarditis, Bacterial / diagnosis*Endocarditis, Bacterial / drug therapyEndocarditis, Bacterial / microbiologyHypothalamic Area, LateralIsosorbide Dinitrate / administration & dosageMitral Valve / diagnostic imagingMitral Valve / microbiologyRetina / diagnostic imagingRetinal Artery Occlusion / drug therapyRetinal Artery Occlusion / microbiology*Streptococcal Infections / complicationsStreptococcal Infections / diagnosis*Streptococcal Infections / drug therapyStreptococcal Infections / microbiologyStreptococcus gallolyticus / isolation & purification*Tomography, Optical CoherenceTreatment Outcomejournal article10.1136/bcr-2020-235763.