Terson's Syndrome
A patient with no known past ocular history was referred for evaluation of bilateral retinal detachments. Prior to his presentation, the patient was admitted to an outside hospital and was diagnosed with a sub-arachnoid hemorrhage originating from the right anterior communicating artery. He underwent embolization and coiling followed by a ventriculoperitoneal shunt. Vision had not improved by the time the patient was discharged. At presentation for the ophthalmic examination, vision was LP in the right eye and HM in the left eye. Intraocular pressure was normal. Anterior segment was normal other than 3+ brunescent cataracts. Posterior exam was limited due to dense vitreous hemorrhage in both eyes. B-scan ultrasound imaging reported vitreous hemorrhages in both eyes and vitreous membranes. In the context of recent hospitalization and ophthalmic exam findings, the patient was diagnosed with Terson’s syndrome. The patient was observed for one month before proceeding with pars plana vitrectomy of the left eye to clear the vitreous hemorrhage. The vision was significantly improved to BCVA of 20/250 in the left eye but there was notable progression of the left eye cataract. The right eye will undergo a similar pars plana vitrectomy procedure in the near future.
Presentation Date: 03/21/2024
Issue Date: 03/29/2024
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