When Sight Fails Suddenly: Acute Vision Loss in a Tricenarian
Sandhya Manorenj1* , Sara Sravan Kumar1
1Department of Neurology, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, India.
*Corresponding Author: Dr. Sandhya Manorenj, Professor, Department of Neurology, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India. https://doi.org/10.58624/SVOANE.2026.07.005
Received: January 26, 2026
Published: February 12, 2026
Citation: Manorenj S, Kumar SS. When Sight Fails Suddenly: Acute Vision Loss in a Tricenarian. SVOA Neurology 2026, 7:1, 23-27. doi. 10.58624/ SVOANE.2026.07.005
Abstract
We describe the case of a 36-year-old right-handed businessman who presented with acute, painless bilateral vision loss. Initial clinical and ophthalmologic examinations did not reveal ocular pathology, and neurophysiological testing showed only borderline abnormalities. Neuroimaging identified bilateral parietooccipital lesions, and subsequent vascular imaging demonstrated severe intracranial internal carotid artery occlusion with collateral vessel formation consistent with Moyamoya vasculopathy. Further review of medical history revealed underlying rheumatoid arthritis with positive RA factor and anti-CCP antibodies, suggesting autoimmune-mediated chronic vasculopathy as the etiology. This case highlights the diagnostic complexity of sudden bilateral vision loss in young adults and emphasizes the rare but significant association between rheumatoid vasculitis and secondary Moyamoya syndrome.
Keywords: Moyamoya Syndrome, Rheumatoid Vasculitis, Bilateral Vision Loss
