Spontaneous vitreous hemorrhage in a young patient with benign intracranial hypertension

Abstract

The case of a 14-year-old boy who presented with spontaneous vitreous hemorrhage in association with otherwise asymptomatic benign intracranial hypertension (BIH) is presented. The blood formed a central retrohyaloid collection at the macula with vitreous breakthrough. The hemorrhage appeared to have come from adjacent to the optic disc although it was never possible to definitely identify its source. There was at no stage any clinical evidence of a peripapillary subretinal membrane. He had suffered a light blow to the head two days before the hemorrhage but this was probably not contributory.

His condition improved with medical therapy and his vision returned to normal with absorption of the blood. The hemorrhage may have been due to raised retinal venous pressure or physical disruption of nerve head vessels caused by the elevation of the disc surface. This case demonstrates that although children do not normally suffer the serious visual complications associated with BIH in adults there is a risk to their vision from spontaneous intraocular hemorrhage.

Key Words:

• benign intracranial hypertension
• vitreous hemorrhage
• visual loss
• papilledema