Multiple bilateral retinal hemorrhages: An unusual presentation of megaloblastic anemia

The purpose is to report the occurrence of bilateral retinal hemorrhages in megaloblastic anemia and its management. A 42-year-old male presented with sudden and painless diminution of vision in both eyes. The ophthalmologic evaluation revealed bilateral white-centered, sub-internal limiting membrane, blot- and flame-shaped hemorrhages near disc, and macula. Hematological evaluation revealed megaloblastic anemia with hemoglobin 6.6 g/dl with no thrombocytopenia. Posttreatment increase in hemoglobin was noted with resolution of retinal hemorrhages and normal foveal contour in both eyes. The careful and detailed ophthalmic evaluation of anemic patients is required for the early diagnosis and management of vision-related complications.