Sneeze-induced visual and ocular motor dysfunction.

Abstract

The purpose of this report is to describe two neuroophthalmic complications that are related by their temporal association with a sneeze. We describe observational case reports of two patients. Both patients were examined, and their conditions were diagnosed and treated according to standard indications for each neuroophthalmic condition. The first case describes a patient who had previously undergone intracranial surgery, including removal of the clivus and later developed a trochlear nerve paresis after a sneeze. The second case describes a patient who repeatedly demonstrates transient decreased perfusion to his right central retinal artery and an associated afferent papillary defect after sneezing. The mechanical and hemodynamic forces involved in sneezing are formidable and may cause permanent cranial neuropathy or temporarily alter ocular blood flow in certain patients.