A forty five year old one eyed known hypertensive and diabetic female presented with huge premacular hemorrhage in her right eye (Only eye). She was restless due to central visual loss and was crying for rapid recovery .
YAG laser intervention to drain this blood away from the macula seems one option.
I don't think that YAG laser will be helpful in this case with such a huge amount of premacular hemorrhage, but it's worth a try.
I would recoomend treating the patient with Q switchedNd:YAG laser with single burst using Goldman three mirror contact lens
Laser energy started with 5-8mj and then gradually increased 1mj each, until a perforation became visible at the surface and blood drainage under gravity into the vitreous cavity was evident. I have used your image and highlighted the areas were you can aim for. After that, do advice the head to be elevated by 30-40 degrees all time (mainly during sleep) (2 pillow head up should be adequate.) Good luck,. ( i have attempted similar in upto 3 disc diameters in both vertical and horizontal dimensions and it does seem to work )
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