[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
July 1974

Spontaneous Expulsive Choroidal Hemorrhage

Author Affiliations

From the Department of Ophthalmology and Laboratory of Ophthalmic Pathology, Scheie Eye Institute and Hospital of the University of Pennsylvania, Philadelphia.

Arch Ophthalmol. 1974;92(1):33-36. doi:10.1001/archopht.1974.01010010037009

A case of spontaneous expulsive choroidal hemorrhage is discussed clinically and histopathologically. Literature review reveals that the ten previously reported cases show similarities to the present case in that at least seven of the subjects and probably nine had glaucoma and all ten subjects had a corneal perforation. A mechanism is proposed for spontaneous expulsiva choroidal hemorrhage that emphasizes glaucoma as the pivotal mechanism because it accounts for the following: (1) bullous keratopathy that may become infected secondarily, culminating in a corneal perforation; (2) a greater decompressive force at the time of corneal perforation with resultant anterior displacement of retina and choroid; and (3) focal ischemia of the posterior ciliary arteries at the point where they enter the glove, weakening the arterial wall and making rupture more likely at the time of sudden decompression.

Grafenberg E:  Hoemophthalmus bei Glaukom . Arch Augenheilk 56:38-52, 1907.
Meller J:  Ueber Spontane Berstung des Augapfels . Klin Monatsbl Augenheilkd 60:458-467, 1918.
Manschot WA:  Telangiectatic granulomas in an eye with spontaneous expulsive hemorrhage . Am J Ophthalmol 43:872-879, 1957.
Pietruschka G, Schill H:  Ueber die Spontane Bulbusruptur . Klin Monatsbl Augenheilkd 145:167-174, 1964.
Williams K, Rentries PK:  Spontaneous expulsive choroidal hemorrhage . Arch Ophthalmol 83:191-194, 1970.Article
Manschot WA:  Glaucoma—vascular necrosis—expulsive hemorrhage . Acta Ophthalmol 23:309-342, 1945.Article
Manschot WA:  The pathology of expulsive hemorrhage . Am J Ophthalmol 40:15-24, 1955.