Posters

Atypical resorption of an unknown post-traumatic hyphema

Poster Details

First Author: K.Belkhadir MOROCCO

Co Author(s): S. Moutamani   K. Tazi   N. Boutimzine   S. Tachfouti   O. Cherkaoui        

Abstract Details

Purpose:

The care of elderly patients with dementia is always difficult. In addition, these patients often have atypical clinical presentations. We report the case of an 80-year-old patient with Alzheimer's disease who was referred to ophthalmic emergencies by her family for a whitish pupillary reflection. The interrogation is difficult and does not allow to have information on the circumstances of occurrence of this lesion.

Setting:

Ophthalmology Unit A, Hopital des Specialites, Mohammed V University in Rabat, Morocco

Methods:

The clinical examination revealed a visual acuity reduced to the perception of light. The biomicroscopic examination showed a whitish plaque contiguous to the corneal endothelium, with a large horizontal axis measuring 6 mm, and a small vertical axis measuring 3.5 mm. Its edges are spiculated, with a reddish blood around the entire lesion. The anterior chamber was seat of a hyphema measuring 1 mm in height. The iris was normal, without sectorial atrophy or rubella,  and the lens had a occlusive cataract. The examination was completed by a B-mode ultrasound, finding an anechoic vitreous and a flat retina.

Results:

Given the atypical aspect of the lesion, the patient benefited  from a complete assessment. All these exams returned without anomalies. We also performed anterior chamber puncture, looking for the herpes virus, or cellular atypia, also returned without abnormalities. Therapeutically, the patient was placed on topical steroids hourly and progressive degression, with a beginning of resorption of plaque after 48 hours of treatment.

Conclusions:

Given the patient's dementia, the initial aspect of the lesion and the negativity of the assessment, we assumed that the patient had to be the victim of an ocular trauma, having caused a post traumatic hyphema, probably total, having regressed leaving a fibrin plate attached to the corneal endothelium. The evolution was favorable, with a decline of 8 months. The occurrence of trauma in the elderly, with comorbidities can lead to atypical lesions, especially when the interrogation does not reveal the process of injury, and when there is a delay of consultation

Financial Disclosure:

None