11/10/2025
Images 1-3 were two/three days later:
organized clot persists in the inferior chamber angle, while lighter erythrocytic haze (micro-hyphema component) remains suspended superiorly.
The previously noted friable vessel at 1 o’clock appears inactive, with no fresh extravasation.
Cornea remains clear, and there is no layering blood staining or endothelial compromise.
IOP remains stable and within physiologic range ( oral and maximum topical therapy at this point )
The patient reports improved vision and comfort, correlating with partial clearance of anterior-chamber blood.
Images 4-6 (five to seven days later):
A) dense clot, dark red to burgundy with patchy lighter pink and yellowish zones near the upper margin — suggesting partial lysis and hemoglobin breakdown.
The color heterogeneity (dark central core with lighter periphery) is consistent with ongoing organization and early resorption, not fresh bleeding.
B) The clot occupies approximately two-thirds of the anterior chamber height, extending centrally and slightly superiorly.
The inferior angle remains partially obscured, though there’s a small clear crescent inferiorly suggesting some settling or reabsorption since earlier stages.
C) The surface is irregular and granular, not smooth — a typical sign of clot contraction and fibrin organization.
There are no visible bright red zones or fresh bleeding streaks, which is reassuring and indicates no active rebleed.
D) Anterior Chamber and Cornea
• The cornea remains clear anteriorly, with no signs of blood staining visible in this image.
• There’s minimal aqueous flare, meaning inflammation is probably controlled at this point.
IOP was in the high teens to mid 20s
8 days later, patient return with severe pain! Pressure spiked back to 50-60 mmhg.
Sent the patient for an emergent AC washout.
She has been discharged now, vision is improving nicely , IOP is 12!
Expected to make full recovery. Will be followed closely for the next few months. What a journey for this young poor girl !
