Timothy Beckman1, Sean Cheng1,2, John Harrison1,2

Purpose: The ophthalmic artery is composed of three anatomical segments; intracranial, intracanalicular and orbital. True intracanalicular ophthalmic artery aneurysms are extremely rare, with only two previous cases reported. Painless, progressive and profound visual loss is caused via compression of the optic nerve. We present a new case discussing appropriate investigations and management considerations.

Method: Review of the literature and summary reported case.

Results: Occlusion of the ophthalmic artery has been shown to return vision to baseline in two cases of intracanalicular ophthalmic artery aneurysms.  Both cases exhibited prior evidence that external carotid collateral vessels provided sufficient vascular supply to warrant safe occlusion of the ophthalmic artery.

Conclusion: In patients who do not demonstrate this collateral blood supply, conservative management is in the best interest of the patient in order to avoid potential ocular ischaemic syndrome.