Association of combined nonarteritic anterior ischemic optic neuropathy (NAION) and obstruction of cilioretinal artery with overdose of Viagra®

Aims: We report on a case of combined nonarteritic anterior ischemic optic neuropathy (NAAION) and cilioretinal artery occlusion resulting from misuse of sildenafil citrate (Viagra (R); Pfizer Pharmaceuticals, New York, NY). Design: This is an observational case report. Methods: A 54-year-old white man developed blindness in his left eye after an overdose of Viagra. He was examined and fully evaluated. Results: Ocular examinations revealed a left relative afferent pupillary defect and a left combined NAAION and obstruction of the ipsilateral cilioretinal artery. Conclusions: Although ocular side-effects of Viagra are rare, they are potentially blinding. Patients should be warned about the side-effects and against misuse of this agent.