Sudden loss of vision in one eye due to massive hemorrhage into the vitreous presents an interesting problem in differential diagnosis. In the absence of diabetes, hypertension, or other systemic disease, a most important consideration is the spontaneous development of a retinal tear, with or without detachment. Another less frequent cause of this clinical picture is exemplified by the patient's history in this case.
Report of Case
A 52-year-old Caucasian woman was apparently well when she suddenly "was able to see only half an object out of the right eye." The following morning her vision in this eye had decreased to bare light perception, and at this time she was examined by an ophthalmologist, who obtained only a dark funduscopic reflex. She was referred to another ophthalmologist for a retinal reattachment operation. Examination on the second day after the onset of visual loss revealed light perception with faulty projection in
GASS JDM. Hemorrhage Into the Vitreous, a Presenting Manifestation of Malignant Melanoma of the Choroid. Arch Ophthalmol. 1963;69(6):778-779. doi:10.1001/archopht.1963.00960040784020