Fig. 15. Dilated tortuous conjunctival vessels in a 63-year-old woman with a presumed dural carotid–cavernous fistula. She presented with a 2-week history of “red eye,” mild retroorbital headache, and double vision. On examination, a left sixth nerve paresis, 3 mm of proptosis, a faint orbital bruit, and slightly elevated intraocular pressure were found. All signs and symptoms resolved spontaneously in 6 weeks, while angiography was being contemplated.