title: Delayed-onset expulsive choroidal hemorrhage attributed to an acute elevation in systemic blood pressure following traumatic globe rupture.
abstract: The authors describe a 78-year-old woman who suffered a traumatic partial dehiscence of a penetrating keratoplasty on the day prior to presentation. While awaiting surgical repair, the patient experienced an expulsive choroidal hemorrhage necessitating a primary evisceration of the eye. This case is unique because the hemorrhage can be largely attributed to the acute dramatic rise in systemic blood pressure that immediately preceded it. Management considerations for patients with open-globe injuries who have poorly controlled systemic hypertension should include close monitoring of vital signs in a controlled setting, anxiolysis, aggressive intervention for hypertensive lability, and hastening of surgical repair regardless of nothing by mouth status.
authors.affiliation: Center for Sight (SAN), Georgetown University Hospital, Washington, DC, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Nissman
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Pasternak
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D001794:Blood Pressure; D002832:Choroid Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D017234:Eye Evisceration; D005131:Eye Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D015948:Keratoplasty, Penetrating; D012421:Rupture; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000150:complications*