An Unusual Case of Intra-Ocular Haemorrhage

Persistent pupillary membranes

“…There have also been reports of PPMs occurring with a variety of other abnormalities of the anterior chamber which in some cases seem to be familial with autosomal dominant inheritance but in our case there was no family history 1213 There have been case reports of spontaneous haemorrhage occurring form PPMs but these are unusual 14…”

Episodes of monocular blurring of vision during breastfeeding

“…Cases of a spontaneous unilateral hyphaema in a 75-year-old woman and a 45-year-old man have been described due to bleeding from iris vessels related to a remnant of the pupillary membrane. 6 , 7 Histological examination of these strands show that the fibrils often contain thin vessels empty of blood. Sometimes the membrane may be attached to the lens and less frequently to the cornea.…”

Spontaneous unilateral hyphema from a strand of persistent pupillary membrane

“…Clinically the remnants of the pupillary membrane are often seen as white strands, in 17.6–31.9% of the cases, but persistent functional vessels are found in only 0.3% which may very rarely bleed. [ 1 2 3 4 ] Our case presented with active bleeding from such a PPM strand.…”

“…Spontaneous hyphema in the anterior chamber is rare and can occur due to certain reasons like intraocular neoplasms, blood disorders (leukemia, hemophilia), uveitis, rubeosis iridis, fibrovascular membranes in retrolental or zonular area (retrolental fibroplasia, persistent primary vitreous, retinoschisis), juvenile xanthogranuloma, occult trauma or trauma with late effect, hydrophthalmos, vascular anomalies of the iris, histiocytosis X, post-glaucoma surgery and very rarely from PPM. [ 1 2 3 4 ]…”

“…Literature search revealed that there are very few cases of bleeding from a strand of PPM in adults and it is extremely rare. [ 1 2 3 4 5 ] Some case reports have documented an iris angiography which showed the anomalous vasculature or aneurysmal dilatation within the PPM strand. [ 2 3 4 5 ] In most of the previously reported cases a predisposing factor, either strenuous effort immediately preceding the bleeding[ 1 2 ] or systemic hypertension[ 3 4 ] contributed in the causation of hyphema; however, Kotamarthi et al .…”