Purtscher-like retinopathy associated with primary hypereosinophilic syndrome

To describe a patient with undiagnosed primary hypereosinophilic syndrome (HES) who presented with Purtscher-like retinopathy and to review the literature.

Observational case report.

A 25-year-old man presented with a 1-week history of bilateral visual blur. Examination revealed multiple peripapillary cotton-wool spots and few intraretinal hemorrhages. Clinical history was obtained and fluorescein angiography, systemic evaluation, laboratory studies, and histopathologic analysis of a bone marrow biopsy specimen were performed.

The patient was diagnosed with primary HES. No previous description was found in the literature.

HES should be considered in the differential diagnosis of Purtscher retinopathy. This case supports the microembolic theory of Purtscher retinopathy.