Retinal Hemorrhages Research Articles

Systemic Tumors and Retina

The eyes are a rare site for systemic metastasis. Metastatic tumors of the eye are more common than primary ocular tumors. The choroid is the most common site for ocular metastases whereas retinal metastases are relatively rare. The retina metastasis of Malignant melanoma, pulmonary carcinoma, breast adenocarcinoma, gastrointestinal carcinoma, uterine adenocarcinoma, and lymphoma was reported. Retinal metastases may cause visual symptoms in patients as well as be asymptomatic. Retinal hemorrhage, retinal mass, retinal or vitreous seeding, vascular occlusion, vitreous hemorrhage, and retinal detachment may be seen due to retinal metastasis. The ocular findings of systemic tumors metastasize to the retina and the approach to the patient are discussed in this review.

Autoimmune Diseases and Retina

Autoimmune diseases are a group of diseases that can result in organ-specific and/or systemic (systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis,...) anatomical deformation and loss of function as a result of the body's immune system attacking its own antigens under the influence of genetic and environmental factors. The eye is a potential target for complications related to autoimmunity, and depending on the severity of the immune response, vision-threatening problems can be observed. Immune complexes accumulate in and around the vessel walls as a result of humoral immunity, in which the autoantibody-related complement system is activated, and cellular immune response can lead to retinal vasculitis, vaso-occlusion, retinal hemorrhage, retinal ischemia, ischemic optic neuropathy, and inflammation of periorbital tissues. Therefore, the role of ophthalmologists in disease management is important in diagnosing, investigating, and treating ocular symptoms in a timely manner. Early diagnosis and treatment can play a critical role to decrease the risk of irreversible immunological damage to the retinal tissue. A multi-disciplinary approach for complete management and evaluation is needed in this disease group. This study aimed to provide a detailed review of the current clinical perspective for the diagnosis, workup, and treatment of autoimmune diseases with retinal manifestations. Systemic lupus erythematosus, Polyarteritis Nodosa, Dermatomyositis, Scleroderma, Wegener's Granulomatosis, Churg-Strauss Syndrome, Takayasu Arteritis, Susac Syndrome, and Nodular Panniculitis are discussed under this heading.

Vitreoretinal Interface Changes After Anti-vascular Endothelial Growth Factor Treatment in Highly Myopic Eyes: A Real-World Study.

To investigate changes in the vitreoretinal interface after anti-vascular endothelial growth factor (anti-VEGF) treatment in highly myopic eyes. Eyes with myopic choroidal neovascularization (mCNV) treated with intravitreal injection of anti-VEGF in a single-center were retrospectively reviewed. Fundus abnormalities and features of optical computed tomography were studied. A total of 295 eyes from 254 patients were recruited to the study. Prevalence of myopic macular retinoschisis (MRS) was 25.4%, and the rates of progression and onset of MRS were 75.9% and 16.2%, respectively. Outer retinal schisis (β = 8.586, p = 0.003) and lamellar macular hole (LMH) (β = 5.015, p = 0.043) at baseline were identified risk factors for progression and onset of MRS, whereas male sex (β = 9.000, p = 0.039) and outer retinal schisis at baseline (β = 5.250, p = 0.010) were risk factors for MRS progression. Progression of MRS was first detected in outer retinal layers in 48.3% of eyes. Thirteen eyes required surgical intervention. Spontaneous improvements of MRS were observed in five eyes (6.3%). Changes in the vitreoretinal interface, such as progression, onset, and improvement of MRS, were observed after anti-VEGF treatment. Outer retinal schisis and LMH were risk factors of progression and onset of MRS after anti-VEGF treatment. Intravitreal injection of ranibizumab and retinal hemorrhage were protective factors for surgical intervention for vision-threatening MRS.

A comparative study of the effect of conventional hemodialysis versus hemodiafiltration on the eye

Background and aim Hemodiafiltration (HDF) seems to be the gold standard concerning dialysis-aided renal replacements. Hemodialysis (HD) and severe renal failure both have visual side effects, including high intraocular pressure, band keratopathy, macular leakage, red eyes, retinal hemorrhage, and optical neuropathy. The purpose of this study is to examine the impact of routine conventional HD versus routine HDF on ocular problems in individuals with chronic kidney disease (CKD). Patients and methods This prospective cross-sectional observational study was conducted on 200 patients divided into 100 patients of CKD on regular HD three times weekly (4 h duration) (HD group) and 100 patients of CKD on regular HDF three times weekly (4 h duration) (HDF group). clinical interview, routine laboratory tests, and complete eye examination were done on all participants. Results Prior to treatment, there was no significant difference between the HDF and HD categories for either eye’s central foveal thickness, average macular thickness, visual acuity, intraocular pressure, anterior segment, or fundus examination. In addition, no significant difference was observed between both groups after therapy in both eyes. Conclusion Regular HDF and HD treatments administered for 6 months each had no negative impact on ocular parameters.

Impact of macular intraretinal hemorrhage and macular hole on the visual prognosis of submacular hemorrhage due to retinal arterial macroaneurysm rupture.

To compare the effects of macular intraretinal hemorrhage (IRH) and macular hole (MH) on best-corrected visual acuity (BCVA) after displacement of submacular hemorrhage (SMH) due to retinal arterial macroaneurysm (RAM) rupture. This multicenter retrospective study included 48 eyes with SMH due to RAM rupture. Cases underwent vitrectomy to displace SMH and were followed up for 6 months. We classified cases according to the presence of IRH and MH and compared the postoperative BCVA among the groups. We classified the eyes into IRH(+)MH(+) group (10 eyes), IRH(+)MH(-) group (23 eyes), and IRH(-)MH(-) group (15 eyes). The postoperative BCVA was significantly worse in the IRH(+)MH(+) and IRH(+)MH(-) than in the IRH(-)MH(-) (0.91 ± 0.41 in logarithm of the minimal angle of resolution units, Snellen equivalent 20/163, 0.87 ± 0.45, 20/148, and 0.18 ± 0.21, 20/30, respectively; P < 0.001). The postoperative CRT was significantly lower in the IRH(+) group (IRH(+)MH(+) and IRH(+)MH(-) groups combined) than in the IRH(-) group (IRH(-)MH(-) group) (121.4 ± 70.1 μm and 174.3 ± 32.9 μm, respectively, P = 0.008). The postoperative ELM and EZ continuities were significantly discontinuous in the IRH(+) group (P < 0.001, P = 0.001, respectively). The multiple linear regression analysis showed that both IRH(+)MH(+) and IRH(+)MH(-) were associated with the postoperative BCVA (regression coefficient, 0.799 and 0.711, respectively ; P < 0.001 for both). Both IRH and MH were poor prognostic indicators in cases with SMH due to RAM rupture.

Central Retinal Vein Occlusion after COVID-19 Infection.

Central retinal vein occlusions are not well-known complications of SARS-CoV-2 infection. We describe a case of central retinal vein occlusion secondary to COVID-19, and a review of the literature was performed. A 47-year-old woman with no underlying ocular or medical condition presented to the hospital complaining about sudden onset of multiple scotomas in her left eye. A COVID-19 infection was confirmed 2 days previously by a PCR test that was performed 2 days after the onset of symptoms. Medical history revealed no risk factors and no oral contraception. Her best-corrected visual acuity was 1.0 in the right eye and 0.04 in the left eye. Clinical exam showed a left relative afferent pupillary defect and a nasally localized papilledema on fundoscopy of the left eye. Multiple dot and blot hemorrhages were also present. Optical coherence tomography revealed cystoid macular edema and paracentral acute middle maculopathy. The results of the fluoresceine angiography were consistent with central retinal vein occlusion. Laboratory workup later revealed an elevated fibrinogen level, corresponding to the COVID-19-induced hypercoagulable state. No other prothrombotic conditions were found. The patient immediately received an intravitreal injection of Lucentis (ranibizumab) after diagnosis. Complete resolution of the retinal hemorrhages and papilledema was observed 1.5 months after treatment and the final visual acuity was 1.25 in the left eye. Coagulation abnormalities are frequently observed in infectious diseases such as COVID-19 infection and the resulting prothrombotic state can sometimes lead to retinal vascular complications, including central retinal vein occlusion, irrespective of the presence of other classical risk factors. The consideration of this information could help clinicians establish a prompt diagnosis and therefore appropriate treatment, which could hopefully lead to complete healing of retinal lesions.

Macular hemorrhage – therapy

Submacular hemorrhage treatment is still an important issue in ophthalmology. At present we lack algorithms of treatment that could be used in clinical practice. Efficacy of every treatment method seems to differ by individual factors simultaneously existing in each patient. Therefore, anti-VEGF agents remain crucial in treating patients with coexisting vasculopathy, while in posttraumatic hemorrhage we should lean towards other approaches, like pneumatic displacement. Operative methods, despite being more invasive and burdened with higher potential risk, are indispensable in large hemorrhages, significantly speeding up clot removal. The primary aim of this work is to collect recent data regarding this issue and to determine usefulness of treatment methods in specific cases, regarding factors such as hemorrhage pathophysiology. The following article pertains to currently used treatment methods, such as: pneumatic displacement, anti-VEGF therapy, rtPA and operative methods.

A Case of Bilateral Optic Neuropathy Following COVID-19 Infection

Purpose: To report a case of bilateral optic neuropathy after COVID-19 infection.Case summary: Thirty-four-year-old woman presented with bilateral ocular pain, visual disturbance, and decreased visual acuity after contracting COVID-19 infection 16 days ago. At the initial visit, best-corrected visual acuity was 0.8 in the right eye, and 0.7 in the left eye. Left eye had relative afferent papillary defect and visual field tests revealed enlarged blind spot in both eyes. Fundus exam showed bilateral optic disc swelling and peripapillary retinal hemorrhage along with vitreous hemorrhage in the left eye. Fluorescein angiography revealed bilateral leakage of dye from the optic disc with area of hypofluorescence corresponding to retinal hemorrhage around the optic disc in both eyes. Brain magnetic resonance imaging (MRI) showed ill-defined left optic nerve enhancement. A diagnosis of bilateral optic neuropathy was made, and the patient was treated with high dose IV steroid 1 g per day for 3 days and oral steroid tapering for 2 weeks. Disc swelling and retinal hemorrhage were improved 1 month after treatment along with enhanced visual acuity to 1.0.Conclusions: Bilateral optic neuropathy following COVID-19 infection showed improvement after steroid treatment.

Multimodal Imaging Characteristics and Risk Factors Analysis of Waldenström Macroglobulinemia Retinopathy

To summarize the multimodal imaging features and analyze the risk factors of Waldenström macroglobulinemia retinopathy (WMR). Retrospective, cross-sectional study. Patients diagnosed with Waldenström macroglobulinemia and underwent ophthalmic examination in Peking Union Medical College Hospital in the last decade were included. Multimodal imaging characteristics of WMR were summarized. Univariate and multivariate logistic regression analysis of WMR and potential systemic and ocular factors was performed. A total of 50 WM patients were included in this study, and 28 patients had WMR in at least one eye. WMR was found to have worse LogMAR visual acuity (VA) (0.52±0.54 vs. 0.21±0.18, p=0.009), and was characterized by tortuous retinal vessels, extensive retinal hemorrhage, and distinctive shape of macular edema, etc. In univariate analysis, the presence of WMR was significantly associated with the mean VA (LogMAR), serum RBC counts, serum PLT counts, HGB level, serum M protein, serum IgM level, and LDH (with p<0.05). In multivariate analysis, WMR was significantly correlated with M protein (adjusted OR=1.127, 95% CI 1.052-1.209, p= 0.001) and serum IgM (adjusted OR=1.059, 95% CI 1.023-1.095, p= 0.001) with the predicted AUC of 0.820 and 0.859, respectively. The optimal cut-off values were 26.2g/L for M protein, and 51.0g/L for IgM, which accounts for a sensitivity of 95.4% and 95.4%, and specificity of 64.3% and 60.7%. Retinopathy of WM has specific characteristics in ophthalmic examinations. Serum IgM levels and M protein are good predictors of WMR, which could attach important value of fundus examinations for WM patients.

Icariside II alleviates ischemic retinopathy by modulating microglia and promoting vessel integrity

Ischemic retinopathies (IRs) are vision-threatening diseases that affect a substantial amount of people. The current treatment options for IRs have side effects and are unable to prevent disease progression. It is therefore worthwhile to consider alternative treatments that could be safer and more efficient. Icariside II (IRS) is a metabolite icariin, derived from traditional Chinese medicine Herba Epimedii. In the oxygen-induced retinopathy (OIR) model, IRS significantly inhibited pathological angiogenesis and retinal hemorrhage dose-dependently. Its efficacy could be regulated by glycogen synthase kinase-3β (GSK-3β) and β-catenin, which may be critical roles in suppression of the activated microglia and exacerbation of pathologic angiogenic process. These results suggest that intake of IRS can be a potentially effective treatment in IRs via promoting the proper angiogenesis architecturally and functionally.

Effects of disorganization of retinal inner layers for Idiopathic epiretinal membrane surgery: the surgical status and prognosis

BackgroundTo compare the surgical status in idiopathic epiretinal membrane (IERM) patients with or without disorganization of retinal inner layers (DRIL) and to correlate with optical coherence tomography angiography (OCTA) and clinical data.MethodsIn 74 eyes from 74 patients with IERM treated by surgery with 12-month follow-up. According to the superficial hemorrhage, the patients were divided into group A (no macular bleeding), group B (macular parafoveal bleeding) and group C (macular foveal bleeding). Optical coherence tomography (OCT) were evaluated for presence of DRIL,central retina thickness and integrity of the inner/outer segment layer recorded at baseline and at 1, 3, 6, and 12 months postoperatively and best-corrected visual acuity (BCVA) was recorded simultaneously. OCTA was conducted at 12 months postoperatively. Main outcome measures is correlation between DRIL and superficial hemorrhage in membrane peeling,and BCVA and OCTA outcomes postoperatively.ResultsThe rate of DRIL and BCVA had statistically significant differences between the three groups at the time points(baseline and 1, 3, 6, and 12 months after surgery), respectively (P < 0.001 for all). FD-300 value (P = 0.001)and DCP in all parafoveal regions (superior: P = 0.001; inferior: P = 0.002;Nasal: P = 0.014;Tempo: P = 0.004) in eyes with DRIL were lower than those without DRIL.There was a linear regression relationship between FD-300 and postoperative BCVA (P = 0.011).ConclusionIERM Patients with DRIL have more intraoperative adverse events and limited benefits from surgery which should be considered in the decision whether to perform mebrane peeling.OCT-A provides more detailed vascular information that extends our understanding of persistent DRIL.

Retinal Hemorrhage after Chiropractic Cervical Manipulation

Retinal Hemorrhage after Chiropractic Cervical Manipulation

Pediatric ophthalmology inpatient consults at a tertiary care children’s hospital

To analyze the pattern of pediatric ophthalmology inpatient consults at a single children's hospital over 5 years. The records of all pediatric ophthalmology consults over a 5-year period were reviewed retrospectively. A total of 1,805 new pediatric inpatient consultations were requested, most commonly for papilledema (14.18%), workup for unknown systemic disease (12.96%), and nonaccidental trauma (8.92%). In 50.86% of consults, an abnormal eye examination was found. When consulted for papilledema or nonaccidental trauma (NAT), we found a positivity rate of 26.56% and 27.95%, respectively. The most common ocular abnormalities noted were orbital/preseptal cellulitis (3.82%), optic disk edema (3.77%), and retinal hemorrhages (3.05%). Over the 5-year period, there was a significant increase in consults to rule out papilledema (P = 0.0001) and for trauma/nonaccidental trauma (P = 0.04) and a decrease in consults for workup of systemic disease (P = 0.03) and to rule out fungal endophthalmitis (P = 0.0007). We found an abnormal eye examination in half of our consults. When consulted for papilledema or nonaccidental trauma (NAT), we found a positivity rate of 26.56% and 27.95%, respectively.

Pediatric abusive head trauma: visual outcomes, evoked potentials, diffusion tensor imaging, and relationships to retinal hemorrhages

PurposeFunction and anatomy of the visual system were evaluated in children with abusive head trauma (AHT). The relationships between retinal hemorrhages at presentation were examined with outcome measures.MethodsRetrospective review of data in children with AHT for 1) visual acuity at last follow-up, 2) visual evoked potentials (VEP) after recovery, 3) diffusion metrics of white matter tracts and grey matter within the occipital lobe on diffusion tensor imaging (DTI), and 4) patterns of retinal hemorrhages at presentation. Visual acuity was converted into logarithm of minimum angle of resolution (logMAR) after correction for age. VEPs were also scored by objective signal-to-noise ratio (SNR).ResultsOf 202 AHT victims reviewed, 45 met inclusion criteria. Median logMAR was reduced to 0.8 (approximately 20/125 Snellen equivalent), with 27% having no measurable vision. Thirty-two percent of subjects had no detectable VEP signal. VEPs were significantly reduced in subjects initially presenting with traumatic retinoschisis or hemorrhages involving the macula (p < 0.01). DTI tract volumes were decreased in AHT subjects compared to controls (p < 0.001). DTI metrics were most affected in AHT victims showing macular abnormalities on follow-up ocular examination. However, DTI metrics were not correlated with visual acuity or VEPS. There was large inter-subject variability within each grouping.DiscussionMechanisms causing traumatic retinoschisis, or traumatic abnormalities of the macula, are associated with significant long-term visual pathway dysfunction. AHT associated abnormalities of the macula, and visual cortical pathways were more fully captured by VEPs than visual acuity or DTI metrics.

RARE CASE OF SPONTANEOUS SUB-RETINAL HAEMORRHAGE ASSOCIATED WITH IDOPATHIC INTRACRANIAL HYPERTENSION

Introduction: Idiopathic Intracranial Hypertension (IIH)is defined as increase in intracranial pressure due to unspecified causes leading to headache, papilledema, and transient vision loss. Usually the patients present with mild visual loss but about 25% may develop permanent visual loss due to irreversible optic disc damage. One rare cause of severe visual loss is subretinal hemorrhage (SRH) due to underlying Subretinal Neovascular membrane.&#x0D; Case Report: We report a case of a 36-year-old man diagnosed with IIH and papilloedema with sudden onset profound visual loss in his right eye. On examination, there was a large peripapillary SRH superior to the disc and involving the macula.We stress the importance of recognizing this uncommon complication of papilledema and discuss the possible causes for developing SRH, its most common outcome and the diagnostic as well as treatment modalities available.&#x0D; Discussion: We stress the importance of recognizing this uncommon complication of papilledema and discuss the possible causes for developing SRH, its most common outcome and the diagnostic as well as current treatment modalities available.&#x0D; Conclusion: This report highlights a rare case of spontaneous sub retinal haemorrhage in a patient with IIH. Measurement of optic nerve sheath diameter can be a vital tool for the diagnosis of raised intracranial pressure in this setting.

Ophthalmic manifestations of ruptured arachnoid cysts in children

Intracranial arachnoid cysts are relatively common in the pediatric population. Rarely, they rupture, leading to acute subdural fluid collections, which can cause a sudden increase in intracranial pressure. The purpose of this study was to characterize ophthalmic sequelae in a large cohort of these patients. The medical records of all children treated for ruptured arachnoid cysts who presented at a single tertiary pediatric hospital for initial assessment between 2009 and 2021 were reviewed retrospectively. Of 35 children treated for ruptured arachnoid cysts during the study period, 30 received ophthalmological examination. Papilledema was found in 57% of these children, abducens palsy in 20%, and retinal hemorrhages in 10%. Of the 30 children, 22 were seen in outpatient follow-up, of whom 5 had a best-corrected visual acuity of 20/40 or worse in one or both eyes at most recent follow-up. Cranial nerve palsies resolved in all cases without strabismus surgery. Given high rates of papilledema, cranial nerve palsies, and vision loss, all children with ruptured arachnoid cysts should be evaluated by pediatric ophthalmologists.

Assessing retinal hemorrhages with non-invasive post-mortem fundus photographs in sudden unexpected death in infancy

IntroductionIn the case of sudden unexpected death in infancy (SUDI), eye examination is systematic to detect retinal hemorrhages (RH) that are a crucial hallmark for abusive head trauma (AHT). The aim of this study is to assess the ability of non-invasive post-mortem fundus photographs (PMFP) to detect RH in case of SUDI.MethodsBicentric retrospective analysis of consecutive cases of SUDI under 2 years of age were managed by two French SUDI referral centers with PMFP by RetCam (Clarity Medical Systems USA). PMFP were reviewed randomly, twice, by three independent ophthalmologists blinded for clinical data.ResultsThirty cases (60 eyes) were included. Median age was 3.5 months (interquartile [1.6; 6.0]). No child died of AHT. Image quality was sufficient to assert presence or absence of RH in 50 eyes (83%). Sufficient quality rate was significantly higher when the post-mortem interval was inferior to 18 h (91%, 42/46) as opposed to over 18 h (57%, 8/14, p=0.0096). RH were found in six eyes (10%), four children (13%), with excellent inter and intra-raters’ concordance (Cohen’s Kappa from 0.81 [0.56–1.00] to 1.00 [1.00–1.00]).ConclusionPMFP can detect RH in case of SUDI and is a relevant systematic screening test to be carried out as soon as the deceased child arrives in the hospital. It can decrease the need of eye removal for pathological examination, but further studies are needed to define the best decision algorithm.

Rhegmatogenous Retinal Detachment in Musculocontractural Ehlers–Danlos Syndrome Caused by Biallelic Loss-of-Function Variants of Gene for Dermatan Sulfate Epimerase

Musculocontractural Ehlers-Danlos syndrome, caused by biallelic loss-of-function variants for dermatan sulfate epimerase (mcEDS-DSE), is a rare connective tissue disorder. Eight patients with mcEDS-DSE have been described with ocular complications, including blue sclera, strabismus, high refractive errors, and elevated intraocular pressure. However, a case with rhegmatogenous retinal detachment (RRD) has not been reported. We report our findings in a 24-year-old woman who was diagnosed with mcEDS-DSE in childhood and presented to our clinic with an RRD in the left eye. The RRD extended to the macula and was associated with an atrophic hole. The patient underwent scleral buckling surgery and cryopexy with drainage of subretinal fluid through a sclerotomy under local anesthesia. The sclera did not appear blue but was very thin at the sclerotomy site. The patient developed frequent bradycardia during the surgery. Subretinal or choroidal hemorrhages were not observed intraoperatively; however, a peripapillary hemorrhage was observed one day after operation. The retina was reattached postoperatively, and the peripapillary hemorrhage was absorbed after one month. The peripapillary retinal hemorrhages, thin sclera, and bradycardia were most likely due to the fragility of the eye. The genetic diagnosis of mcEDS-DSE played an important role before and during the surgery by alerting the surgeons to possible surgical complications due to the thin sclera.

Biomarkers of macular neovascularisation activity using optical coherence tomography angiography in treated stable neovascular age related macular degeneration

BackgroundThe aim of this study was to describe features of disease activity in patients with treated stable macular neovascularisation (MNV) in neovascular age related macular degeneration (nAMD) using optical coherence tomography angiography (OCTA).MethodsThirty-two eyes of 32 patients with nAMD were included in this prospective, observational study. These patients were undergoing treatment with aflibercept on a treat-and-extend regimen attending an extension to a 12-week treatment interval.ResultsAll subjects had no macular haemorrhage and no structural OCT markers of active MNV activity at the index 12-week treatment extension visit. 31/32 OCTA images were gradeable without significant imaging artefact. The mean MNV size was 3.6mm2 ± 4.6mm2 and 27 (87.1%) had detectable MNV blood flow. 29/31 (93.5%) subjects had MNV with mature phenotypes including 10 non-specific, 10 tangle and 3 deadtree phenotypes. MNV halo and MNV central feeder vessel were noted in 18 (58.1%) and 19 (61.3%) of subjects respectively; only 1 (3.2%) subject was noted to have a MNV capillary fringe.ConclusionsMNV blood flow is still detectable using OCTA in the majority of subjects in this study with treated stable MNV. OCTA features associated included MNV mature phenotype, MNV feeder vessel, MNV halo and absence of capillary fringe.

Ocular Manifestations in Pregnancy-Induced Hypertension at a Tertiary Level Hospital in Karnataka, India.

Introduction Pregnancy-induced hypertension (PIH) is a hypertensive disorder in pregnancy that occurs after 20 weeks of pregnancy in the absence of previously known hypertension. PIH is a common and serious complication accompanying pregnancy. Pre-eclampsia and eclampsia are multisystem disorders that can involve end organs like kidneys, liver, eyes, haematopoietic system and placenta. Though ocular involvement is not uncommon in PIH, ocular examination is not always done in all cases of PIH. Timely detection of changes in retinal vasculature can be a hint to the underlying changes in the vascular system of the various end organs of the human body including placental circulation. Adequate management of PIH is very important for both fetal and maternal well-being. Aim To evaluate the ocular manifestations in women affected by PIH (mild pre-eclampsia, severe pre-eclampsia and eclampsia) presenting to a tertiary-level hospital. Methodology This was a hospital-based cross-sectional study carried out for a period of one year at a tertiary-level hospital. A total of 120 subjects diagnosed as cases of pre-eclampsia/eclampsia admitted to the eclampsia ward of the obstetric unit formed the study population. After taking history, a detailed ocular examination was done for all patients and the findings were noted. Results The mean age of the study population was 31.91 ± 4.38 years (range 21 to 39 years). The mean gestational age was 30.89 ± 3.98 weeks. Fifty-three (44.17%) were primigravida, 64 (53.33%) were multiparous, and three (2.5%) were grand multiparous. Sixty-two (51.67%) had mild pre-eclampsia, 50 (41.67%) had severe pre-eclampsia and eight (6.67%) had eclampsia. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) recorded in the study were 155.32 ± 11.89 mmHg and 104.3 ± 11.41 mmHg respectively. Ocular symptoms were present in 43 (35.83%) participants. Blurring of vision (19.17%)was the commonest ocular symptom observed in the study population followed by photopsia (13.33%), diplopia (9.17%), intermittent loss of vision (5.83%), ocular pain (6.67%), and scotoma (1.67%). Systemic symptoms included headache (11.67%), epigastric pain (3.33%), and nausea (5%). Anterior segment findings like conjunctival congestion, lid edema, and subconjunctival hemorrhage each accounted for 1.67% of the study population. Fundal changes were present in 33.33% of cases. Arteriolar narrowing was the commonest fundal finding amounting to 15.83%, followed by arteriovenous (AV) crossing changes also in15.83%, cotton wool spots in 5.83%, retinal haemorrhages in 8.33%, papilledema in 2.5%, and choroidal infarcts in 1.67% participants. Grade 1 hypertensive retinopathy was observed in 15.83% of participants, grade 2 in 8.33% of participants, grade 3 in 6.67% of participants and grade 4 in 2.5% of participants. The mean SBP and mean DBP were high among those with fundal changes (163.35 ± 10.25 mmHg and 111.15 ± 10.29 mmHg) compared to those without fundal changes (151.3 ± 10.58 mmHg and 100.88 ± 10.41 mmHg). This was statistically significant. Proteinuria showed significant correlation with retinal changes. Conclusion The retinal vasculature changes correlate with the severity of hypertension, hence, it is very important to seek ophthalmologic opinion for evaluation, diagnosis and prompt management of PIH.