Unilateral Roth spots secondary to uterine leiomyoma.

We report a rare case of a female patient in her early 50s who presented with unilateral transient visual symptoms that resolved shortly. On examination, the anterior segment exam was unremarkable bilaterally; however, her fundus examination showed unilateral anaemic retinopathy, including Roth spots. Her blood tests showed iron deficiency anaemia due to chronic menorrhagia, and her abdominal ultrasound scan showed large uterine fibroids. The gynaecology team was involved; medical therapy failed to control her heavy menstrual bleeding and subsequently correct her anaemia; thus, surgical management was advocated. After undergoing hysterectomy with bilateral salpingectomy and left oophorectomy, her blood testing normalised, and the anaemic retinopathy completely resolved.