BACKGROUND AND PURPOSE Carotid cavernous fistula can present with myriad of symptoms and can often be misdiagnosed. The purpose of the study is to evaluate different clinical manifestations, management and outcome of treatment in direct CCF (type-A) carotid cavernous fistula. MATERIALS AND METHODS A retrospective study of patients who were diagnosed and treated for Type-A CCF in a tertiary care centre attached to a Medical College in Chennai. The case records of 28 patients were analysed.

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... y, clinical presentations and modality of treatment of each patient were recorded and clinical features were compared with that of the outcome. RESULTS Total of 28 patients from 9 years to 51 years were evaluated; 24 (85.7%) patients had history of trauma and in 4 (14.3%) patients CCF developed spontaneously; 25 (89.3%) patients had undergone interventional procedure and 3 (10.7%) had spontaneous thrombosis. None of the patients developed morbidity or mortality related to the procedure. CONCLUSION CCF should be included in the differential diagnosis of any atypical red eye, especially when associated with tinnitus. Ophthalmologist has an important role in the diagnosis of CCF and in the management of certain vision threatening complications like exposure keratopathy, secondary glaucoma or management of residual diplopia.