Purpose: To present a case of vaso-vagal syncope (VVS) after mydriatic eye drops in a patient with cutaneous hemangioma and intracerebral vascular abnormalities. Case report: A 41-year old woman presented to an ophthalmology clinic complaining of near vision disturbance. On examination, there was dilatation and telangiectasis of the conjunctival vessels on the temporal side of the right eye associated with right hemicranial and neck cutaneous involuted hemangioma ipsilateral to the conjunctival lesion. The patient experienced vaso-vagal syncope for approximately 15 minutes after mydriatic eye drops, 2 months prior to presentation. A magnetic resonance angiogram (MRA) showed right hypoplasia of the lateral and sigmoideus venous sinus ipsilateral to the external right hemangioma with predominantly compensatory drainage at the contralateral left system. At the neck vessels, the MRA showed dominant drainage through the lateral and jugular left sinus by the hypoplasia of the contralateral right system. Conclusion: This case shows the association of telangiectasis of the conjunctiva, and cutaneous hemangiomas of the head and neck with anomalies involving the central nervous system (CNS) as described by Pascual-Castroviejo in 1978, which they called cutaneous hemangioma–vascular complex syndrome. The diagnosis was made after the patient experienced VVS after mydriatic eyedrops instillation.

Purpose: To describe an hemiretinal vein obstruction secondary to a congenital arteriovenous malformation. Methods: Case report of a young patient with retinal arteriovenous malformation and hemiretinal vein obstruction. Results: A 9-year-old girl had a grade II retinal arteriovenous communication in her left eye. She presented with sudden loss of vision in her left eye, and a diagnosis of a hemiretinal vein obstruction secondary to a congenital arteriovenous malformation complicated with macular edema, capillary nonperfusion and neovascularization of the retina was made. She received intravitreal bevacizumab and multiple sessions of laser photocoagulation. Magnetic resonance imaging of the brain was normal and disclosed no signs of Wyburn-Mason syndrome. During follow up the patient remained with stable visual acuity, involuted disease, and persistent macular edema. Conclusions: Awareness of retinal vascular obstruction associated with arteriovenous communication may aid early recognition, and prompt treatment of potential complications, such as retinal and iris neovascularization.

Purpose: To report two patients with petechial hemorrhages in the skin of the face and eyelids and subconjunctival hemorrhages after they were exposed to acute severe gravitational force. Methods: Two patients developed Perthes syndrome after they were exposed to an unrestrained acute increase of gravitational force in a park attraction. One of them lost his consciousness for few minutes. The mechanism behind this entity is the sudden rise in the cervicofacial venous system pressure. Results: In our two cases there were no long-term complications encountered and there was spontaneous resolution. Conclusion: Perthes syndrome independently of the cause can lead to ophthalmic, neurological and even life threatening consequences. Proper clinical examination is warranted upon evaluating a patient with such entity.