Relative afferent pupillary defect: an unusual manifestation of carotid artery dissection.

We report the case of a man with a carotid dissection who had relative afferent pupillary defect (RAPD) that persisted throughout his hospital course. Other causes for RAPD were quickly ruled out. Carotid dissections often have ophthalmic manifestations-including RAPD, which, although uncommon as a presenting sign, can be tested for with the swinging flashlight test.