A woman in her mid-50s with a history of hyperlipidemia and arthritis presented with recurrent subconjunctival hemorrhages and retinal vascular abnormalities as noted by her general ophthalmologist. Best-corrected visual acuity was 20/20 OU. Results of the pupillary examination, intraocular pressure measurements, motility, and confrontatiol visual field testing were normal in each eye. Findings on the anterior slitlamp examination demonstrated rare anterior chamber cells and mild nuclear sclerotic cataracts in both eyes. Results of the dilated fundus examination (Figure 1) demonstrated bilateral vitreous cells that were not dense enough to obscure retinal vessel details, as well as optic disc hyperemia, arterial attenuation, arterial and venous sheathing, hard exudates, and focal areas of retinal thinning. There was no macular edema in either eye. Results of a complete blood cell count were normal.
Farooq AV, Lim JI. Subconjunctival Hemorrhages and Retinal Vascular Abnormalities. JAMA Ophthalmol. 2015;133(2):217-218. doi:10.1001/jamaophthalmol.2014.4847