Visual Acuity Changes with a Position Shift in a Patient with an Endocapsular Hematoma

Purpose: To report a vitrectomy performed on a patient with an endocapsular hematoma whose visual acuity changed with her position. Case summary: A 92-year-old woman visited our hospital complaining of a visual acuity change in her left eye with good visibility while standing but poor visibility when lying. She was taking aspirin, had underlying hypertension, diabetes, and heart failure, and underwent left eye cataract surgery 15 years previously. At presentation, her best-corrected visual acuity in the left eye was 0.5, with an intraocular pressure of 23 mmHg. An endocapsular hematoma that partially covered the fundus in the left eye was found. The left eye was observed for 3 months. However, there was no change in the endocapsular hematoma and the discomfort persisted with the position shift; therefore, a vitrectomy, posterior capsulotomy, and anterior chamber irrigation were performed. One month postoperatively, the visual acuity in the left eye was 0.4 and there was no longer a change in the visual acuity with position. Conclusions: A patient with an endocapsular hematoma may have changes in visual acuity with position, and a vitrectomy can be used to treat the endocapsular hematoma.