Subhyaloid haemorrhage

206 Subhyaloid haemorrhage



Instruction


Examine this patient’s fundus.



Salient features



History




• Sudden, painless loss of vision


• Sudden appearance of floaters and black spots with or without flashing lights


• History of stroke (subarachanoid haemorrhage)


• History of diabetes, retinal tears, vitreous detachment, retinal vein occlusion


• History of trauma.



Examination




• A large, solitary subhyaloid haemorrhage (there may be no fluid level if the patient is lying flat) (Fig. 206.1)


• There may be associated retinal haemorrhage


• Mild papilloedema in 20%


• Comment on any obvious hemiplegia.


image

Fig. 206.1 Funduscopic photograph of a subhyaloid haemorrhage.


(With permission from Field, Heran 2010.)


Note: When the subhyaloid (preretinal) haemorrhage extends into the vitreous humour it is called Terson syndrome (Fig. 206.2).


image

Fig. 206.2 Terson syndrome.


(With permission from Yanoff, Duker 2008.)



Diagnosis


This hemiplegic patient has a subhyaloid haemorrhage (lesion) caused by subarachnoid haemorrhage (aetiology).



Advanced-level questions




What is the commonest cause of subhyaloid haemorrhage?


Subarachnoid haemorrhage.

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Dec 4, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Subhyaloid haemorrhage

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