Which description represents the Carotid-Cavernous Fistula triad?

• A. Carotid-Cavernous Fistula: Chemosis, pulsatile proptosis, ocular bruit
• B. Carotid-Cavernous Fistula: Proptosis, optic neuropathy, entropion
• C. Carotid-Cavernous Fistula: Chemosis, diplopia, cataract
• D. Carotid-Cavernous Fistula: Conjunctival injection, uveitis, glaucoma

Answer: (A)

The key idea is the classic triad of Carotid-Cavernous Fistula: chemosis, pulsatile proptosis, and an ocular bruit. Chemosis comes from venous congestion of the conjunctiva, giving swollen, elevated conjunctival tissue. Pulsatile proptosis occurs because arterial blood shunts into the cavernous sinus, increasing orbital venous pressure so the eye sits forward and pulses with the heartbeat. The ocular bruit is a palpable or audible turbulent flow sound over the orbit due to the high-flow fistula.

Other descriptions mix in features like entropion, cataract, uveitis, glaucoma, diplopia, or optic neuropathy, which may occur with ocular vascular issues but do not constitute the classic triad. The combination of chemosis, pulsatile proptosis, and an orbital bruit best represents Carotid-Cavernous Fistula.