Generalised exudative retinal detachment, choroidal 
infarction and cortical blindness are known visual threatening 
conditions in patients with pre-eclampsia/eclampsia. Localised 
macula detachment is an uncommon ocular feature in this 
emergency obstetric situation. A 33-year-old woman presented 
with features of severe pre-eclampsia at 26 weeks of gestation. 
She underwent an emergency lower segment cesarian section at 
27 weeks with blood pressure of 180/100 during the crisis. She 
complained of visual loss three days after delivery. Ocular 
examination revealed visual acuity of 5/60 OD and 6/60 OS, and 
exudative detachment of macula in both eyes. The ocular findings 
resolved completely at three weeks post crisis, while blood 
pressure gradually reached normotensive level at six weeks after 
delivery. Acute severe rise of blood pressure in pregnant women 
with pre-eclampsia/eclampsia causes terminal arterial vasopasm. 
It leads to breakdown of blood retinal barrier and exudation of 
fluid into sub-retinal space. Aim of management is prioritized at 
stabilizing blood pressure without morbidity or mortality to both 
mother and fetus. We provide a literature review of similar cases 
from 2011 to 2017 with emphasize on blood pressure level during 
the crisis, sites of detachment and final visual acuity. Aggressive 
management of pre-eclampsia/eclampsia patients is essential. 
Majority had satisfactory final visual outcome. Level of blood 
pressure may not be related to sites of retinal detachment. A large 
prospective cohort is needed to evaluate this association 
objectively.