The effect of unsuspected carotid-cavernous fistula in enucleation

An 18-year-old man with an unsuspected carotid-cavernous fistula underwent enucleation as the result of a severe localized perforating ocular trauma. Potentially lethal bleeding occurred that was difficult to control. Auscultation of the orbit should be performed in all cases before eye enucleation to avoid the possibility of overlooking a carotid cavernous fistula.