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Ultrasonographic biomicroscopic study of an intracorneal hematoma
1Department of Ophthalmology, Nagoya University School of Medicine, Aichi, Japan.
Purpose:
To demonstrate the importance of ultrasonographic biomicroscopy for following the clinical course of an intracorneal hematoma of unknown origin.
Methods:
A 64-year-old woman was referred to the Nagoya University Hospital because of a decrease in vision in her left eye. Her visual acuity was 20/70 (uncorrectable) in the left eye and the slit-lamp biomicroscopic examination showed a dark red-colored intracorneal hematoma in the central area of the left eye at the pre-Descemet's membrane level. Because the hematoma was small without any epithelial involvement and ultrasonographic biomicroscopy (UBM) and slit-lamp biomicroscopy showed a low risk of a pupillary block, she was followed without surgical treatment.
Results:
The hematoma turned yellow and grew smaller, and UBM images showed an internal liquified cyst 10 months after her initial visit. The cystic legion was detected as a low-echoic cavity by UBM 2 months before it was observed by slit-lamp biomicroscopy. The hematoma was almost resolved 2.5 years after the onset, and the visual acuity OS improved to 20/30.
Conclusion:
The intracorneal hematoma occurred without any obvious cause and should be classified as spontaneous. UBM combined with slit-lamp biomicroscopy was useful in estimating the extent of the hematoma and thus the risk of pupillary block. It was also helpful in deciding whether surgical treatment was necessary.