A glimmer of hope – Bi lateral Terson’s syndrome in a child who is having promising results following surgical intervention: A case report and long term follow up

Author: Thanura Hewage (Sri Lanka)

Co-authors: P. Sri Haranathan

Purpose

This report describes a child with bilateral Tersons syndrome and subsequent surgical management with visual rehabilitation and its long term follow up results.

Setting/Venue

This study was conducted in department of ophthalmology, National Hospital Kandy Sri Lanka

Methods

A retrospective case report of 10 month old child with bilateral Tersons syndrome following fall of a coconut over her head and its sub sequential ocular management and outcome up to her age of 4 is presented.

Results

Ocular management started after 2 months of treatment at neurosurgical unit for Left frontal Sub Dural Hemorrhage, Bilateral frontal Sub Arachnoid Hemorrhage. Preliminary examinations revealed negative hope for surgical intervention such as bilateral dense vitreous hemorrhage, unseen retina, and sluggish pupillary reactions and non-recordable VEP. Surgery was planned following parents consent. Both eyes went 23G lens sparing vitrectomy, at one month gap starting from right eye.Follwoing uneventful surgery intensive visual rehabilitation done. Over four years follow up best corrected visual acuity improved from bilateral No perception of light to right 6/18 and left Hand Movements without long term complications of surgery such as cataract and glaucoma.

Conlusions

Studies have shown no difference in final visual acuity between patients who were conservatively managed and those who underwent Pars Plana Vitrectomy. However, visual recovery was more rapid in the vitrectomised patients. Patient is a young child who is having higher risk of stimulus deprivation amblyopia. So early surgical intervention was done which lead to progressive improvement of vision on left eye.

Financial Disclosure

nil