Factor V leiden is an inherited disorder of blood clotting causing hypercoagulability and can often lead to retinal vein occlusions. This purpose of this case report is to present a spontaneous sub-hyaloid macular hemorrhage and impending retinal vein occlusion in a young woman found to be positive for factor V leiden. She was treated with YAG laser to open the posterior hyaloid face. This led to complete resolution of the hemorrhage with return of 6/6 visual acuity. We conclude that YAG laser treatment is an affective treatment in spontaneous sub-hyaloid macular hemorrhage in a positive factor V leiden patient. This is the first case study of spontaneous macular hemorrhage in a patient with such a mutation. This report also demonstrates the efficacy of YAG laser for premacular hemorrhage, which produces a rapid resolution and improvement in visual acuity.
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