# Terson Syndrome Diagnosed by Ocular Point of Care Ultrasound on the Medical Floor

## TL;DR

A case study shows how ocular ultrasound on the medical floor helped diagnose Terson syndrome, a rare complication of brain injury.

## Contribution

Demonstrates the utility of ocular point of care ultrasound in diagnosing Terson syndrome in acute intracranial disease.

## Key findings

- Ocular POCUS identified vitreous hemorrhage in a patient with subarachnoid hemorrhage.
- Terson syndrome was diagnosed days after initial presentation when ophthalmoscopy was not feasible.
- Ocular POCUS can be a valuable tool in assessing ocular complications during rehabilitation.

## Abstract

In acute care environments, accurately assessing complications of intracranial pathology can be challenging. Ocular complications in acute intracranial disease are not consistently evaluated despite their high morbidity. We report on a case of monocular diplopia in a 63-year-old man with subacute traumatic brain injury with localized subarachnoid hemorrhage. Ocular point of care ultrasound (POCUS) identified features of vitreous hemorrhage in one globe, leading to a diagnosis of Terson syndrome and a timely referral to ophthalmology. This finding was made on the medical floor days after the initial presentation during rehabilitation when ophthalmoscopy was not possible, and vitreous hemorrhage had not been identified on presentation. Terson syndrome is a seldom discussed but important complication of intracranial hemorrhage generally associated with poor patient outcomes. Ocular POCUS can provide a useful alternative in assessing ocular complications of acute intracranial disease on the medical floor, particularly when the practicalities of performing ophthalmoscopy are challenged.