Terson Syndrome: A Sequel of Posterior Communicating Artery Aneurysm and a Quartet of Other Cases

This is a case series of Terson syndrome (TS) in five patients including one with features of a posterior communicating artery aneurysm. The first is a 28-year-old female who presented to the eye clinic with poor vision in both eyes for 2 weeks duration and drooping of the left upper lid. On ocular examination, she had a bilateral vitreous haemorrhage (VH). She gave an antecedent history of headaches, loss of consciousness, and seizures. Magnetic resonance angiography confirmed the diagnosis of a posterior communicating artery aneurysm. Four other patients were seen at the retina clinic with bilateral VH with a history of traumatic brain injury in keeping with TS. The second patient was a 34-year-old male referred from the neurosurgical unit on account of visual loss in both eyes. He had a preceding history of a fall with loss of consciousness and moderate head injury and best corrected visual acuity of counting fingers and hand movement, respectively, in the right and left eye. Bilateral VH was present in both eyes. The third patient was a 60-year-old male with a 2-month history of poor vision in both eyes after a head injury associated with loss of consciousness. The visual acuity was hand movement, and he had VH in both eyes. The fourth patient was a 10-year-old female who presented with poor vision for two months duration with an antecedent history of a pedestrian road traffic accident and a history of loss of consciousness. The best corrected visual acuity at presentation was 6/36 in both eyes. Ocular examination revealed bilateral VH. The fifth case was a 31-year-old male who presented with a reduction of vision in both eyes for 7 months duration with an antecedent history of a fall 2 months before the onset of symptoms. A diagnosis of TS was made in all five patients based on the clinical history and signs. The second patient was managed with bilateral vitrectomy, whereas the remaining four patients were managed conservatively.