Dr.SASHWANTHI MOHAN
A 58 year old lady had bilateral spontaneous suprachoroidal hemorrhage (SCH) during phacoemulsification in left eye and 3 months later in right eye, though all preoperative precautions were taken to prevent it. She had systemic hypertension which was under control and no ocular risk factors. SCH was managed medically and best corrected visual acuity improved to 20/20 in both eyes. However, with clue from her medical history of having had a surgery for arteriovenous malformation on her chin and lower lip 25 years ago, we investigated further and found marked thickening of choroid in both eyes, 684 and 584 microns (220-290 is age corrected normal). This increased choroidal thickness suggested a possible underlying choroidal vascular abnormality, likely a subclinical hemangioma which predisposed the patient to SCH. In presence of facial or other systemic malformations, we recommend B-scan Ultrasound and enhanced depth imaging OCT to help rule out co-existing chorodial vascular abnormality
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