DOI: https://doi.org/10.36347/sjmcr.2025.v13i12.040

Pages: 3058-3061

Purpose: To report a rare case of four-quadrant hemorrhagic suprachoroidal detachment (SCH) with partial retinal detachment during cataract surgery, emphasizing the role of serial ultrasonography in diagnosis, monitoring, and surgical planning. Observations: A 75-year-old man with exfoliative glaucoma and well-controlled hypertension experienced a pre-expulsive SCH during cataract extraction following a capsular bag disinsertion and intraoperative hypertensive surge. Postoperative B-scan ultrasonography revealed four-quadrant dome-shaped choroidal elevations, progressing to a bilobed “kissing choroid” configuration by day 7, with minimal liquefaction. Serial ultrasonography guided timing of delayed surgical drainage, while topical and systemic corticosteroids were administered. Progressive resorption was observed at one month, although some detachment persisted. Conclusions: SCH with extensive choroidal detachment is a rare but severe complication of intraocular surgery. Serial ultrasonography is essential for diagnosis, monitoring liquefaction, assessing detachment extent, and determining optimal timing for surgical intervention. Awareness of risk factors, prompt recognition, and structured perioperative management can improve outcomes.