Intraocular cholesterol crystals

Visual prognosis in advanced Coats disease is generally poor, 5 and if not treated can lead to a blind painful eye secondary to neovascular glaucoma but early cases can respond very well to treatment with good visual outcomes. 6 The mainstay of treatment is cryotherapy and laser to the abnormal retinal vessels to limit exudation. Ocular cholesterolosis has also been reported following vitreous haemorrhage, hyphaema, trauma, chronic ocular inflammation or chronic retinal detachment. 7 8 The crystals are thought to precipitate from the breakdown products of red blood cells or from the lipid exudate which typifies Coats disease. 9 In our case, we believe transudation of lipid occurred across the retina due to either idiopathic retinal holes associated with the primary pathology or possibly iatrogenically induced holes secondary to cryotherapy and laser.