On initial examination the patient was afebrile with a best-corrected visual acuity was 20/32 in the left eye and 20/20 in the right. The left upper lid was edematous and the globe proptosed by 6mm (Figure 1). There were reduced extraocular movements in all directions. The intraocular pressures were 12 in the right eye and 36 in the left. Gonioscopy revealed open angles, there was no afferent pupillary defect and the optic discs were not swollen. Visual fields to confrontation were full and Ishihara testing was normal.
Given her past history, a presumed diagnosis of variceal hemorrhage was made.