Dr.Manmath Kumar Das, Dr.Shrutakirty Parida

Abstract

A 51year female presented with sudden diminution of vision in both eyes along with severe headache for 3 days. She was a known hypertensive (B.P controlled with medications) with no H/O of any head or ocular injury. Her BCVA was CF1/2 M, <N36 in both eyes. Anterior segment examination findings were normal except for sluggish pupillary reaction. Dilated fundoscopy revealed intraretinal, subretinal and preretinal hemorrhages. Hemogram depicted severe hypochromic microcytic anemia. With a provisional diagnosis of anemic retinopathy, she was planned for vitrectomy. On day 1 post-vitrectomy, she complained of intractable headache and breathlessness. She also had 2 episodes of seizures, intermittent loss of consciousness and was then shifted to neuro surgery ICU. NCCT Brain revealed diffuse sub arachnoid haemorrhage. With a combination of these clinico-radiological findings, a final diagnosis of Terson syndrome was made.