The revised international classification of VKH is divided into incomplete, complete, and probable based on the systemic and ocular features [
5]. Our index case did not have any skin, auditory, or neurological manifestations except for headache. MRI brain showed deep white matter lesions in the parietal lobes which were previously described as radiologic features of VKH syndrome [
6]. She was found to have incomplete VKH syndrome based on the typical clinical and angiographic features in the absence of previous ocular surgery and trauma. However, presence of retinal hemorrhages was found to be unusual. Infective and hematological workup was within normal limits. There are case reports of atypical VKH syndrome noted in patients with leukemia [
7,
8]. Choroidal infiltrations of leukemic cells with secondary RPE dysfunction can cause bilateral exudative retinal detachment mimicking VKH-like picture [
9]. They can also present with auditory and neurological features as well as proliferative retinopathy with Roth spots, exudates, and hemorrhages. To our surprise, the peripheral smear was normal. Hence, we started the patient on high dose corticosteroids. Patient responded well with the resolution of both exudative retinal detachments and hemorrhages. We still cannot found out the cause of retinal hemorrhages and its resolution. Temporal association between retinal hemorrhages and VKH cannot be established in the index case; hence, the patient is in constant follow-up for any recurrences of same kind in the future. To our knowledge, retinal hemorrhages in acute uveitic phase of primary VKH syndrome are extremely rare. Retinal peripapillary hemorrhages along with optic disc edema have been previously reported in an observational case series of VKH syndrome in acute phase. Among 52 patients, 6 were found to have optic disc edema with hemorrhages secondary to anterior ischemic optic neuropathy [
10]. Increase in retinal capillary fragility can occur in bullous rhegmatogenous detachment which can cause retinal hemorrhages, but our index case did show only few pockets of subretinal fluid which might not had increased the capillary fragility. Increase in venous pressure secondary to optic disc edema can also cause retinal hemorrhages, which was not found in our index case.