Purtscher’s retinopathy: A case of severe bilateral visual loss due to chest compression

Abstract

We report a case of bilateral Purtscher’s retinopathy in a young man following a motor vehicle rollover accident. Decreased vision was noticed on the fifth day following the trauma. Visual acuity in the right eye was close counting finger, and left eye, counting finger one meter. There was no evidence of direct ocular, head or facial trauma. Purtscher flecken, pre-retinal and retinal hemorrhages were present in both eyes. The right eye showed optic disc edema and more extensive areas of capillary dropout. Patient was treated with intravenous methyl prednisolone. After 5 weeks the right eye vision improved to counting finger one meter and left eye improved to 6/18. Early detection, proper documentation and treatment of the underlying causes in these cases is very important in order to avoid medico-legal pitfalls.