The ophthalmology service at Tufts Medical Center was consulted urgently to examine a hospitalized 78-year-old man at bedside who had developed sudden onset severe right eye pain and ecchymosis while asleep in his hospital bed.
The patient had no ocular or surgical history and was not on any eye medications. His medical history included chronic kidney disease, type 2 diabetes, myelodysplastic syndrome, systemic macrocytosis, chronic thrombocytopenia, recurrent epistaxis, alcohol use disorder and cirrhosis. During his current and prolonged hospitalization, the patient was diagnosed with a new