Because the ophthalmic artery is a branch of the internal carotid artery, obstruction of the internal carotid can cause ocular ischemic syndrome. In over 90 percent of cases, patients complain of gradual vision loss, but sudden blindness can occur. Some patients with ocular ischemic syndrome experience eye pain, caused by ischemia or glaucoma due to new vessel formation in the anterior chamber angle. Ocular ischemic syndrome results in dilated retinal veins with hemorrhages, new vessel formation and soft exudates. The new vessels and microaneurysms are often very friable, resulting in hemorrhage.
Laser photocoagulation can prevent hemorrhage from new vessels.
The cause and location of carotid stenosis should be identified and rectified if possible. Trauma and exposure to water predispose the epithelium of the ear canal to otitis externa. The initial inflammation leads to accumulation of debris that exacerbates edema and narrowing of the canal. Early or mild cases of otitis externa may be treated with removal of debris by dry mopping and instillation of 3 percent hydrogen peroxide solution, followed by application of an antipseudomonal ototopical agent. More severe cases may require treatment with analgesics, oral antibiotics or topical preparations containing steroids.