Abstract
PURPOSE: To describe unique features surrounding the etiology, diagnosis, and management of a rare presentation of hemorrhagic detachment of Descemet membrane. OBSERVATIONS: A 91-year-old woman with chronic marginal corneal degeneration and corneal neovascularization of both eyes presented with hemorrhagic detachment of Descemet membrane of the right eye. CONCLUSIONS AND IMPORTANCE: This case highlights the need to consider pre-Descemet hemorrhage on the differential diagnosis for anterior segment hemorrhage even in the absence of risk factors such as surgery and trauma. This case, initially thought to represent a hyphema, underscores the importance of anterior segment imaging in accurate diagnosis and monitoring of this condition. Lastly, this case illustrates a management approach that successfully cleared the hemorrhage, reattached Descemet membrane, and restored visual acuity without keratoplasty.