Vitreous Hemorrhage from Papilledema After Neck Massage

Abstract

A 41-year-old woman presented with left eye floaters after receiving a head and neck massage while prone. The patient had a history of idiopathic intracranial hypertension, treated with acetazolamide. Examination revealed a left inferior optic disc hemorrhage and bilateral optic disc edema (A-B). OCT of the left optic nerve depicted retinal nerve fiber edema with hyperreflectivity in the preretinal space extending into the vitreous (C). OCT retinal nerve fiber layer confirmed bilateral disc edema (D). This case represents active disc hemorrhage observed on OCT imaging secondary to idiopathic intracranial hypertension and exacerbated by pressure from massage, which induced venous rupture on the optic disc (Magnified version of Figure A-D is available online at www.aaojournal.org).