Secondary surgical management of expulsive choroidal hemorrhage

Eight cases of expulsive hemorrhage with herniation of intraocular contents were managed with secondary procedures after initial operative closure of the eye. Two eyes with giant retinal tears and clear vitreous were treated with photocoagulation alone; each regained 20/200 visual acuity. Vitreous hemorrhage, traction retinal detachment, or rhegmatogenous retinal detachment was an indication for surgery in six eyes. Vitrectomy, choroidal drainage with simultaneous intraocular infusion, and scleral buckling restored useful vision in two eyes. In cases without vitreous hemorrhage or retinal detachment, conservative management may yield good results, while intraocular surgery may salvage useful vision in more complicated cases.