Purtscher’s-like retinopathy as a complication of acute pancreatitis

Purtscher’s-like retinopathy is a rare occlusive microvasculopathy occurring in the absence of trauma, recognised as a complication of systemic conditions including acute pancreatitis.

We present the case of a woman in her 40s admitted with a 5-day history of worsening epigastric pain and vomiting. Investigations confirmed acute pancreatitis, and 2 days into her admission, she developed bilateral visual disturbances. Initial symptoms were attributed to opiate analgesia and subsequently to alcohol withdrawal, resulting in a delay of several days before the correct diagnosis was reached. Funduscopy and optical coherence tomography revealed findings consistent with Purtscher’s-like retinopathy. Conservative management of the pancreatitis was continued with no acute ophthalmic intervention. Six months following her recovery from pancreatitis, the patient reported gradual but incomplete visual recovery with significant ongoing impairment. This case highlights the importance of ophthalmological assessment in patients with acute pancreatitis presenting with visual impairment and the need for clinician awareness of Purtscher’s-like retinopathy in non-traumatic settings.