Acute Bilateral Painless Vision Loss in a Pediatric Patient With Infective Endocarditis

Abstract

Infective endocarditis (IE) is a complex cardiac condition with a myriad of systemic complications, affecting approximately 5% of patients with ocular manifestations. This report details a rare and severe presentation of IE, marked by the acute onset of bilateral vision loss attributed to central retinal arterial occlusion (CRAO) and posterior ischemic optic neuropathy (PION), both critical conditions resulting from vascular impairments associated with IE. CRAO, characterized by the sudden obstruction of blood flow to the retina, leads to rapid vision deterioration, showcasing the critical impact of vascular emboli originating from infective endocardial lesions. On the other hand, PION, a less common vascular disorder, affects the posterior segment of the optic nerve, typically sparing the optic disc from edema but resulting in significant visual impairment. This case emphasizes the importance of recognizing ocular symptoms in patients with IE, as early detection and intervention are vital for managing these rare but devastating complications.