Retinal bleeding in a pregnant patient with optic nerve head drusen

Optic nerve head drusen (ONHD) are retained hyaline bodies located on the anterior aspect of the optic nerve. They are described as small, white crystalline or yellowish-white round globules, often seen as an elevated "lumpy" disc with irregular or "scalloped" margins. The exact etiology remains unclear but it is proposed that optic nerve drusen result from altered axonal transport in a narrowed scleral canal. Periodic examinations are recommended to monitor for potential vascular complications. Hemorrhages are not an unusual presentation with optic nerve head drusen and the type of hemorrhage present may be a clue for the underlying etiology and potential management options. This paper presents a case of peripapillary hemorrhaging associated with optic nerve head drusen in a 25-year-old, pregnant, Caucasian female.