When a patient presents with a Sub ILM bleed, it is quite often confused with a sub hyaloid haemorrhage. In such situations, there are subtle imaging clues that can help with the diagnosis. The management is tricky in the sense of whether to observe, laser or surgically intervene, as currently there are no official guidelines in the literature. This video clip is about a 50 year old healthy female who was diagnosed with sub ILM haemorrhage over the macula (Valsalva retinopathy) after a bout of severe vomiting. She was treated with vitrectomy with ILM peeling. This case highlights the diagnostic pearls in cases of large sub ILM haemorrhage along with subtle yet useful surgical management tips. It also showcases a variety of distinctive functions that are inbuilt in our vitrectomy machines which most surgeons seldom use. A month later post op, the patient regained her complete vision back and the retina was crystal clear.
VT0061 – ACHOOO…God bless you!
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