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A 16-year-old boy with pseudoxanthoma elasticum noted blurred vision in his right eye after being hit on the right brow by a volleyball. Previously, the visual acuity had been 20/20 in both eyes, with no history of ocular difficulty. On examination his vision was found to be 20/40 - 3 in the right eye and 20/20 - 1 in the left with correction. There were abrasions and ecchymoses of the right eyelids and angioid streaks in the fundus of both eyes. Neck lesions typical of pseudoxanthoma elasticum were present. In the right eye, there were multiple subretinal hemorrhages that seemed to follow the path of the angioid streaks (Fig 1 and 2). There were no hemorrhages anterior to the equator. In the left eye (Fig 3), numerous angioid streaks were present, but no hemorrhages. Fluorescein angiography showed the typical picture of angioid streaks, and there was a late leak in
Levin DB, Bell DK. Traumatic Retinal Hemorrhages With Angioid Streaks. Arch Ophthalmol. 1977;95(6):1072-1073. doi:10.1001/archopht.1977.04450060159017