Subacute Terson Syndrome in a Patient With Monocular Vision After Craniofacial Ballistic Injury

Purpose: This retrospective case report describes the diagnosis, treatment, and clinical outcome of subacute Terson syndrome in a patient with monocular vision following craniofacial ballistic injury. Methods: A single case and its findings were analyzed. Results: A 26-year-old man presented to the retina clinic 5 weeks after a gunshot injury to the right craniofacial region. At presentation, the patient, who was rendered monocular from the gunshot injury, reported experiencing vision loss in the uninjured left eye during the postacute period. Dilated examination of the left eye revealed hand motion visual acuity with dense vitreous hemorrhage. A 25-gauge pars plana vitrectomy of the left eye was performed, during which multiple sub-internal limiting membrane hemorrhages characteristic of Terson syndrome were discovered and evacuated. Visual acuity was restored to 20/25 by postoperative week 2. Conclusions: The excellent visual outcome achieved by vitrectomy within 1 week of presentation demonstrates the importance of (1) retaining Terson syndrome in the differential diagnosis for patients with vision loss after nonaneurysmal central nervous system injury, and (2) expediting surgical intervention, particularly in patients with monocular vision.