Purpose: To describe an unusual hemorrhagic complication associated with pupillary dilation in a patient with exfoliation glaucoma taking anticoagulation therapy.
Methods: A 78-year-old woman with bilateral exfoliation glaucoma who was receiving warfarin, 2 mg daily, for systemic anticoagulation developed acute visual loss in the right eye several hours after pupillary dilation.
Result: Examination disclosed bilateral advanced exfoliation glaucoma, localized vascularized iridolenticular adhesions in the right eye, and a 4-mm layered hyphema in the right eye.
Conclusion: Patients with exfoliation glaucoma and vascularized posterior synechiae who are receiving anticoagulation therapy are at increased risk for visually significant spontaneous hyphema after pupillary dilation.