Spontaneous hemorrhagic Descemet membrane detachment: Imaging, diagnosis, and management

To describe unique features surrounding the etiology, diagnosis, and management of a rare presentation of hemorrhagic detachment of Descemet membrane.

A 91-year-old woman with chronic marginal corneal degeneration and corneal neovascularization of both eyes presented with hemorrhagic detachment of Descemet membrane of the right eye.

This case highlights the need to consider pre-Descemet hemorrhage on the differential diagnosis for anterior segment hemorrhage even in the absence of risk factors such as surgery and trauma. This case, initially thought to represent a hyphema, underscores the importance of anterior segment imaging in accurate diagnosis and monitoring of this condition. Lastly, this case illustrates a management approach that successfully cleared the hemorrhage, reattached Descemet membrane, and restored visual acuity without keratoplasty.