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JAMA Ophthalmology Clinical Challenge
February 2015

Subconjunctival Hemorrhages and Retinal Vascular Abnormalities

Author Affiliations
  • 1Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago
  • 2CME Editor, JAMA Ophthalmology
JAMA Ophthalmol. 2015;133(2):217-218. doi:10.1001/jamaophthalmol.2014.4847

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.