Premacular sub-internal limiting membrane (sub-ILM) haemorrhage is a known cause of sudden profound loss of vision. Neodymium-doped yttrium aluminium garnet (ND-YAG) posterior hyaloidotomy is an inexpensive, effective and safe treatment modality for rapid drainage of haemorrhage covering the macula. An 18-year-old male patient presented to us with a history of Nd-YAG posterior hyaloidotomy for Valsalva-related premacular bleed. At the posterior pole, a cavity formed by the detached ILM with a central defect in ILM-posterior hyaloid complex was evident. High-definition optical coherence tomography (HD-OCT) showed normal foveal contour with a parafoveal macular hole. Hence, good clinical judgement, appropriate positioning of hyaloidotomy and use of lowest possible energy level is the key to a successful and safe laser drainage of a premacular haemorrhage.
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Contributors RB contributed to the conception and design, acquisition of data or analysis and interpretation of data. RC gave final approval of the version published and agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved. SVA and BT contributed to the drafting of the article or revising it critically for important intellectual content.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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