Spontaneous Suprachoroidal Hemorrhage
A pseudophakic, myopic patient presented with acute left eye pain, nausea, and hypertensive crisis (BP 220/84) and was found to have intraocular pressures in the 50s with a spontaneous suprachoroidal hemorrhage. Initial B-scan demonstrated 360° bullous, non-serous ciliochoroidal detachment extending anterior and posterior to the equator; the retina remained attached and no mass or calcification was identified. Serial ultrasonography over four weeks showed gradual regression of choroidal elevation, but no retinal detachment or appositional choroidals developed. The patient was managed conservatively with topical corticosteroid, cycloplegia, and intraocular pressure control, with avoidance of NSAIDs and systemic blood pressure optimization. By six weeks, imaging demonstrated marked regression with minimal residual elevation, visual acuity improved, intraocular pressure normalized, and drops were discontinued. This case highlights the role of serial B-scan monitoring and conservative management in select cases of spontaneous suprachoroidal hemorrhage without retinal detachment or persistent angle compromise.
Presentation Date: 02/26/2026
Issue Date: 03/27/2026
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