A fourteen years old Malay boy was involved in a motor vehicle accident and suffered multiple injuries. The patient was referred to ophthalmology for right periorbital haematoma,ocular examination was normal but proptosis of right eye was detected which was later associated with increase in the intraocular pressure (IOP). Direct carotid cavernous sinus fistula (CCF) was diagnosed by angiography and treated with embolization. 