Abstract
Background:to highlight the importance of a complete ophthalmologic examination in patients with hemianopia.
Case presentation: a 19-year-old female patient who underwent craneotomy for hematoma and brain herniation due to ruptured left temporal arteriovenous malformation was referred to ophthalmology from neurosurgery due to right hemianopia complaints.
In the examination, she showed best-corrected visual acuity of 20/25 in right eye and 20/200 left eye, in confrontation campimetry temporal hemianopsia in right eye and not assessable in left eye due to low visual acuity. Funduscopic examination showed mild papillary paleness in right eye and central fibrinoid hemovitreous in left eye that required surgical vitrectomy with good evolution. After surgery, the patient presented an improvement in visual acuity, but not in her right homonymous hemianopia.
Conclusions: Terson’s syndrome diagnosis worsens the vital prognosis and clinical outcomes of patients with intracraneal hemorrhages and could seriously compromise the vision. Although imaging test detect most intraocular hemorrhages and some previous manuscript concluded that could replace routine ophtalmologic examinations, we found the presence of a visually significant vitreous hemorrhage inadvertent in previous serial imaging test.We want to emphasize, by this case report, the importance of funduscopy examination in patients with intracraneal hemorrhages even when radiological tests do not show intraocular hemorrhages.