# Spontaneous Expulsive Suprachoroidal Hemorrhage in a Middle-Aged Patient With Hypertension, Type II Diabetes, and Associated Retinopathy

## TL;DR

A middle-aged man with hypertension and diabetes experienced a rare eye condition involving spontaneous bleeding behind the eye, requiring multiple surgeries to treat.

## Contribution

This case highlights the importance of recognizing and managing choroidal vessel vulnerability in patients with SESCH.

## Key findings

- The patient presented with massive preretinal hemorrhage due to SESCH.
- Surgical interventions successfully reduced intraocular pressure and pain.
- Choroidal detachment was visible during cataract surgery.

## Abstract

We report the clinical course of spontaneous expulsive suprachoroidal hemorrhage (SESCH) in a middle-aged man. A 50-year-old man with a history of uncontrolled hypertension and type II diabetes presented with massive preretinal hemorrhage in the posterior pole of the right eye (RE). Two weeks later, he presented with elevated intraocular pressure (IOP) and a nearly obliterated anterior chamber with coagulated blood behind the lens in the RE. We performed two rounds of surgery, including cataract surgery, vitrectomy, and sclerotomy. The choroidal detachment was clearly visible behind the posterior capsule during the cataract surgery. The surgical intervention successfully lowered the IOP and alleviated the pain. In rare cases of SESCH, maintaining awareness when patients show vulnerability in their choroidal vessels is of high importance.