Vitreous Haemorrhage

Background

  • Vitreous haemorrhage is blood in the vitreous chamber of the eye.
  • It is commonly associated with retinal tears and proliferative diabetic retinopathy/ARMD (with the formation of new vessels) (including CRVO)

Presentation

  • Floaters are the most common symptom.
  • The patient may also have loss of vision (haze) if the haemorrhage is large.
  • There is normally no pain or any other significant problems.  If there are, then a more serious cause should be considered.
  • Examination
    • Haemorrhage may be seen in the vitreous chamber on ophthalmoscopy.
      • It may be difficult to focus on it as it can extend a depth of the vitreous.
    • It may also be difficult to focus on the fundus, depending on the cause of the haemorrhage.
    • The cause should be sought at examination (see ARMD/retinal detachment/diabetic retinopathy).

Management

  • Patients may be advised to keep their head elevated and eyes patched for a while to let the blood settle.
  • The underlying cause, where known, should be treated appropriately e.g. retinal detachment repair; laser treatment for proliferative disease
    • In severe (non-clearing)/recurrent cases, vitrectomy may be required

 

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