When Preeclampsia Blinds: Bilateral Retinal Detachment in Hypertensive Pregnancies

Introduction:Preeclampsia is a multisystemic hypertensive disorder of pregnancy affecting 5–8% of gestations worldwide and remains a major cause of maternal and perinatal morbidity and mortality [1–3]. Visual symptoms occur in up to 25% of patients and are usually transient; however, serous retinal detachment is a rare but vision-threatening complication, occurring in approximately 1–2% of severe cases and up to 10% in eclampsia [4,5]. This condition results from choroidal ischemia and dysfunction of the retinal pigment epithelium secondary to intense arteriolar vasospasm and endothelial damage [6–8]. Case Series:We report three cases of adolescent pregnant patients diagnosed with severe preeclampsia who developed bilateral serous retinal detachment. The mean age was 17 years. All patients presented with headache and acute bilateral visual loss. Retinal detachment was confirmed by fundoscopy and optical coherence tomography (OCT). Management included cesarean section, systemic antihypertensive therapy, and corticosteroid treatment. Intensive care support was required in all cases. Progressive improvement of visual function was documented in each case, with full recovery over 5 to 6 weeks. Discussion:Although rare, bilateral retinal detachment should be considered in pregnant women presenting with acute visual disturbances in the setting of hypertensive disorders. Prompt diagnosis and timely multidisciplinary management—particularly involving obstetrics, ophthalmology, and intensive care—are key to preventing permanent visual sequelae and ensuring maternal-fetal safety. Conclusion:Serous bilateral retinal detachment represents a rare but reversible ophthalmic complication of severe preeclampsia. Early recognition and multidisciplinary intervention can lead to complete visual recovery. Obstetricians should maintain a high index of suspicion when managing hypertensive pregnant patients with visual symptoms.