BACKGROUND: Central retinal artery occlusion (CRAO) is an ocular emergency and 
most of the cases present with painless sudden persistent loss of vision in the 
range of counting fingers to perception of light. The presentation of CRAO is 
associated with a variety of medical conditions. We report a rare case of CRAO 
associated with persistent truncus arteriosus (PTA) and single atrium in a 
female patient.
CASE PRESENTATION: A 23-year-old woman was admitted due to sudden painless 
visual loss in the left eye. On examination visual acuity of light-perception 
was noted in the left eye with a left relative afferent pupillary defect. 
Fundoscopic examination revealed retinal ischemic whitening, constriction of the 
arteriole and venule with segmentation and typical "cherry-red spot" suggesting 
CRAO. The patient was treated with ocular massage and anterior chamber 
paracentesis. She was commenced on 150 mg of aspirin and also received 
hyperbaric oxygen therapy. An echocardiogram revealed PTA and single atrium. A 
diagnosis of CRAO associated with PTA and single atrium was made.
CONCLUSION: The ophthalmologist should enquire about congenital and acquired 
cardiac abnormalities in patients with CRAO and consider such abnormalities to 
be possible sources of emboli.