Purtscher's retinopathy in pre-eclampsia: a blinding combination.

Blindness in pregnancy can occur due to cortical infarcts, retinal vascular occlusions and retinal detachment. Purtscher's retinopathy is a rare entity causing visual loss during pregnancy and has so far been reported in association with complicated labor. We report here on a case of Purtscher's retinopathy leading to bilateral blindness in a pre-eclamptic multigravida after an uncomplicated spontaneous delivery. The patient had no visual recovery after 3 months postpartum. Poorly controlled pregnancy-induced hypertension coupled with the hypercoagulable state of pregnancy probably led to a compromised optic nerve microvasculature and loss of retinal autoregulation. Subsequently the acute event of parturition triggered a complement-mediated leucocyte embolization to this already compromised microvasculature resulting in Purtscher's retinopathy.