Spontaneous Amsler's sign - A unique presentation

Abstract

Amsler's sign is the characteristic filiform haemorrhage and hyphaema seen in cases of Fuch's heterochromic iritis, following the needle removal during paracentesis.[1] The source of bleeding is from abnormal fragile iris vessels.[2] It commonly occurs after procedures like applanation tonometry, gonioscopy and even during pharmacological mydriasis.[1] Unusual presentations have been reported after Honan ball use, peribulbar block, and intraoperatively.[3] Six cases of spontaneous Amsler's sign without any intervention have been reported, where two of them were seen only through gonioscopy.[1] Fig. 1 shows spontaneous microscopic hyphaema during routine preoperative examination that could be attributed to trivial trauma like eye rubbing.[4] Figure 1 (a) Spontaneous filiform haemorrhage (arrowhead) in Fuch's heterochromic iridocyclitis with stellate Keratic precipitates (arrow) and mature cataract (star). (b) Hyphaema (arrowhead) captured gonioscopically in the same patient Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.