[Recurrent spontaneous hyphema assosiated with focal iris vascular leakage-successful treatment with argon laser...

Spontaneous non-traumatic anterior chamber bleeding is rare and may be caused by focal vascular iris changes at the pupillary margin. A 53-year-old woman presented in 01/2024 with painless sudden visual loss in the left eye. Findings: a localized reddish vascular lesion at the 2 o'clock pupillary margin, no hyphema, no inflammation, and intraocular pressure of 15 mm Hg. In 02/2025, recurrence occurred with erythrocytes in the anterior chamber, renewed bleeding from the localized reddish vascular lesion at the pupillary margin, and IOP rise to 24 mm Hg. Iris fluorescein angiography showed localized hyperfluorescence with leakage. After initial pressure-lowering therapy, targeted argon laser photocoagulation was performed. This led to rapid stabilization without further bleeding or pressure elevation. The findings remained stable through 11/2025. The case highlights the diagnostic value of iris fluorescein angiography and the effectiveness of focal argon laser photocoagulation.