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Serpentine blood clot
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This photo of a patient who presented for a “red spot” in her eye was chosen as the winner of this month’s “Ocular Photography Challenge.”
James Spangler, OD, of Warren, Pa., said the patient had been seen for several years for Fuch’s endothelial dystrophy and epithelial basement membrane disease of both corneas. Her vision was corrected to 20/20- in each eye.
When the patient came in due to the red spot in her eye, Dr. Spangler saw this serpentine blood clot in the anterior chamber overlying the iris. She was taking levothyroxine and quinidine for arrhythmia, but no blood thinners or aspirin. She was seen 11 days later, and the hemorrhage had completely resolved, with trace residual cells present.
Gonioscopy revealed a peripheral anterior synechia extending to the margin of an old cataract surgery incision. This is an unusual case to occur near an incision from a surgery performed 16 years ago.
There was no neovascularization of the iris or anterior chamber angle, no neovascularization or ischemic areas of the retina and only mild macular degeneration changes without leakage.
Quinidine has been associated with thrombocytopenia (low platelet count), although she did not have a history of bruising. The information was forwarded to the patient’s primary care physician.
The patient was monitored for later hemorrhage, but none has occurred. Treatment would consist of photocoagulation of the specific area of leakage.
This photo was taken with the EyeRes Slit Lamp Camera.
As this month’s winner, Dr. Spangler will receive an HA-2 Handheld Tonometer, provided by Kowa.
Submissions for the contest can be e-mailed to nhemphill@slackinc.com. They are judged anonymously by a panel of Primary Care Optometry News Editorial Board members.
Please provide a photo of at least 300 dpi, a 100-word description of the case including what imaging system was used and the name of your home town. Photos may not have been previously published. You will be asked to grant permission to SLACK Inc. to publish your photo.
Contestants are permitted to win once a year. Kowa provides the prizes, including one annual grand prize awarded to the winner chosen from among each round’s winners. Delivery of prizes may take up to 120 days.