Occlusion of the central retinal artery in Plasmodium falciparum malaria

A 40-year-old woman presented with sudden painless diminution of vision in left eye. The best corrected visual acuity was 20/20 in the right eye and 20/400 in the left eye. The vision loss occurred 3 days after the onset of fever with chills and rigour. Rapid diagnostic test and peripheral blood smear examination revealed Plasmodium falciparum malaria. The left eye fundus showed a pale disc with marked attenuation of arterioles. A detailed systemic evaluation including cardiovascular, haematological and angiographic assessments was performed which did not reveal any abnormality. A diagnosis of central retinal artery occlusion (CRAO) associated with uncomplicated P. falciparum malaria was made. In this communication, we report that acute loss of vision in a patient with P. falciparum malaria, CRAO needs to be ruled out.