Case Report of Terson’s Syndrome Suggesting Pathway of Subarachnoid Hemorrhaged Blood into Eye

Abstract

Aims: The pathway of subarachnoid hemorrhaged blood into the eye in Terson’s syndrome has not been definitively determined. We present our findings in a patient with Terson’s syndrome that provided clues on how the subarachnoid hemorrhaged blood entered the eye. Presentation of Case: A 47-year-old man visited our department three months after a subarachnoid hemorrhage. His visual acuity was hand motion in the right eye and light perception in the left eye. B-scan ultrasonography showed dense vitreous opacities in both eyes and a total retinal detachment in the left eye. Vitrectomies were performed on both eyes. An old subretinal hemorrhage was found in the right eye. A circular opacity firmly attached to the posterior capsule of the lens was found during the vitrectomy on the left eye. His final visual acuity was 20/20 in the right eye and 20/400 in the left eye. Discussion and Conclusions: The subretinal hemorrhage in the right eye suggests the blood spread along the choroid. The localized circular sublenticular opacity in the left eye suggests that the blood reached the posterior capsule of the lens through the hyaloid canal. A review of the development of the eye suggests that the blood can flow into the eye through the subarachnoid space in the choroid fissure and the choroid in eyes with Terson’s syndrome.