Nafis ur Rahman, Nafis Ur Rahman.
Treatment of Macular Sub-Hyaloid or Sub Internal Limiting Membrane Haemorrhage by Nd:Yag Laser.
Pak J Ophthalmol Jan ;17(2):63-4.

Sub hyalold or sub internal limiting membrane haemorrhage has been associated with severai conditions e.g. age related macular degeneration, proliferative diabetic retinopathy, valsalva i retinopathy, macroaneurysms and trauma. This case report Is about a healthy patient who developed macular sub hyalold/sub Internal limiting membrane haemorrhage in his left eye without any obvious reason which dropped his visual acuity to 5/60. Early treatment with Nd:Yag laser resulted in dramatic improvement in visual acuity to 6/6 unaided.

CASE REPORT: A 28-year-old otherwise healthy male presented with a sudden decrease of vision in his left eye of one-day duration. There was no history of trauma, diabetes mellitus, hypertension or valsalva maneuver. He was not on any medications. His eyesight had previously been good. On examination the visual acuity in his right eye was 6/6 while the visual acuity in the left eye was reduced to 5/60, which could not be improved with glasses. A dilated fundus examination revealed a normal right fundus and a left macular sub hyaloid /sub internal limiting membrane haemorrhage. The intraocular pressures were 14mmHg in both eyes. Blood tests including complete blood cell counts, platelet count, blood glucose and bleeding and clotting times were normal. The patient was treated with Nd:Yag laser aimed at the anterior surface of the preretinal haemorrhage using a fundus contact lens and a pulse of 1.3mJ and increasing it gradually. Two small openings were created in the posterior hyaloid at 2.9mJ with blood flowing into the vitreous cavity. One hour after treatment the visual acuity had improved to 6/36 and 24 hours after laser treatment the visual acuity had improved to 6/6 unaided. No pathologic condition was detected once the haemorrhage had cleared. The site of bleeding could not be identified.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com