A case presentation of Spontaneous Expulsive Suprachoroidal Haemorrhage
Author: Alex Manton (United Kingdom)
Co-authors: ,Stella Hristova, William Saldana, Fraser Peck
To describe the clinical features of a case of Spontaneous Expulsive Suprachoroidal Haemorrhage, to discuss the risk factors and management for this rare condition.
Ophthalmology Department, Eastbourne District General Hospital, Eastbourne, United Kingdom
A single case study of a 72 year old male patient who attended the Emergency Department following an atraumatic, acute, initially painful total loss of vision. At presentation visual acuity was no perception of light in the left eye and 0.9 in the right eye. On examination a expulsive suprachoroidal haemorrhage was diagnosed with almost complete loss of corneal tissue. This patients past ophthalmic history includes poorly controlled primary open angle glaucoma, previous bacterial keratitis and he is pseudophakic. Due to the destructive nature of this condition visual recovery was suggested to be unlikely; evisceration was suggested to be the appropriate management.
Suggested mechanism for suprachoroidal haemorrhage from literature is decompression of the eye most commonly during surgery with or without choroidal effusion resulting in rupture of choroidal or ciliary vessels. It is likely that chronic raised intra-ocular pressure resulted in a large drop in IOP following a corneal rupture most likely caused by an undiagnosed bacterial keratitis. This loss of tamponade resulted in expulsion of intra-ocular contents. The patient was eviscerated and a good surgical outcome was achieved.
There are very few case reports of this rare condition. Those that are reported are seen on the back of poorly controlled glaucoma, steroid use or significant corneal disease.
Secretariat Address European Society of Retina Specialists Ground Floor, The Apex Building Blackthorn Road
Sandyford Business Park
Co Dublin, D18 H6K2