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Case 26


Patient Presentation: A 41-year-old woman with a known history of idiopathic intracranial hypertension (IIH) presented with a 2 day history of painless decreased vision OS. The patient noted she had a head and neck massage in prone position 2 hours prior to her visual disturbance. She was using 500mg PO Diamox daily. On examination, visual acuity was 20/20 OD and 20/40 OS. There was no RAPD. Fundus photographs were taken and are shown below:


An OCT ONH/RNFL was taken and is shown below:


Question 1: What is the main finding in the OCT ONH/RNFL above?

An OCT 5-line raster over the left optic nerve was taken and is shown below:


Question 2: What is the main finding in the left eye OCT 5-line raster above?


  1. Di Ianni J, Pereira A, Micieli JA. Vitreous Hemorrhage from Papilledema After Neck Massage. Ophthalmology. 2023;doi:10.1016/j.ophtha.2022.12.015

Learning Objectives:

  1. To recognize an optic disc hemorrhage on OCT imaging.

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