The authors record a rare case of hypertensis crisis complicated by stroke, intracranial haemorrhage and unilateral intraocular haemorrhage after methamphetamine (pervitin) overdose in a 16-year-old boy had led to a hypertensive crisis giving rise to Terson's syndrome: intracranial haemorrhage, elevation of intracranial pressure and subsequent unilateral intraocular haemorrhage. In the course of 19 days of intensive care with artificial pulmonary ventilation, the intracranial pressure oscillated between 20 and 40 mmHg, central left hemiparesis occurred and right-side intravitreal haemorrhage was diagnosed by an ophthalmologist.
After three months of insufficient spontaneous resorption of intravitreal haemorrhage, we performed pars plana vitrectomy (PPV). Visual acuity in the right eye improved after surgery from 6/24 to 6/9.
With modern intensive care and optimal timing of PPV, Terson's syndrome should be recognized as a reversible cause of blindness in patients surviving intracranial haemorrhage.