Undiagnosed malignant hypertension presenting as a direct spontaneous carotid-cavernous fistula with complete loss of vision and hyphaema

A 60-year-old woman presented with complete loss of vision in the right eye (RE) with progressive protrusion and complete drooping of the right eyelid since 1 week ([figure 1A,B][1]). There was no history of trauma and patient was not on any systemic medications. Ocular examination revealed tense