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Cases are presented as an initial image with history and examination. Health practitioners are encouraged to deduce the condition, before further investigations, diagnosis and management are presented.

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Colour fundus photography of the left eye demonstrates a left submacular haemorrhage.

Case 22

Figure 1. Colour fundus photography of the left eye demonstrates a left submacular haemorrhage.

Author: James Leong     Editor: Adrian Fung

A 59-year-old female was referred with acute painless loss of central vision in her left eye.

Case history

A 59-year-old Asian female presented to her optometrist 5 days after noting sudden loss of central vision in her left eye. She had no significant past ocular or medical history. The optometrist noted a large left submacular haemorrhage and referred her urgently for a further opinion and management.

On examination her right (OD) visual acuity was 6/5 and left (OS) visual acuity count fingers. Intraocular pressures were 21mmHg (OD) and 19mmHg (OS). Anterior segment examination was unremarkable. Posterior segment examination demonstrated a large left submacular haemorrhage. Within the haemorrhage and in the adjacent macula were reddish-orange polypoidal lesions (Figure 1). The contralateral fundus examination was normal.

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