Referral delay and ocular surgical outcome in Terson syndrome

In Terson syndrome, vitreous hemorrhage can result from intracranial hypertension associated with intracranial bleeding. The vitreous hemorrhage can cause a considerable visual handicap. The aim of this study was to determine the outcome of surgery in patients with Terson syndrome and any delay in referral to an ophthalmologist.

Retrospective case review of 25 eyes of 17 patients undergoing vitrectomy for Terson syndrome. Delay in presentation to an ophthalmologist, intraoperative and postoperative complications, and the final visual acuity were noted.

The mean interval between visual symptoms and referral to an ophthalmologist was 5.2 months for the nine unilateral cases and 4.9 months for the eight bilateral cases. Intraoperative complications included retinal break (2) and retinal dialysis (3). Late complications included epiretinal membrane (4), ghost cell glaucoma (1), and cataract (8). Twenty-two of the 25 eyes achieved a final visual acuity of 20/30 or better.

Vitrectomy for vitreous hemorrhage in Terson syndrome is a safe and effective procedure, offering a rapid and prolonged improvement in vision. There is good reason to consider early vitrectomy, particularly when the hemorrhage is bilateral and dense.