Vitreous Hemorrhage

Vitreous hemorrhage, or bleed, results in a sudden change in vision as it blocks light moving through the vitreous to the retina. This hemorrhage specifically occurs in front of the retina in the posterior section of the eye.

Vitreous hemorrhage should be considered in patients with diabetes mellitus, hypertension, and trauma.

Causes

There are a various causes of vitreous hemorrhage. The most common is bleeding from abnormal blood vessels growing on the retina (neovascularization). When portions of the retina receive inadequate blood supply, usually as the result of diabetes or blockage in a blood vessel, these areas produce a chemical which stimulates blood vessel growth.

Symptoms

• Painless event
• Gradual or sudden loss of vision that may vary from normal vision to only light perception.
• Black spots with flashing lights that move with eye movement is a common complaint. Some patients report seeing a red haze.
• Usually a unilateral process, but bilateral involvement has been reported.

Signs

• Anterior chamber, usually normal
• Mild afferent pupillary defect may be present (possibly associated with retinal detachment).
• Red light reflex may be decreased or absent.
• Inability to visualize the fundus is common with large vitreous hemorrhages.

Treatment

Sometimes treatment is not needed for vitreous hemorrhages. Your doctor may suggest bed rest with your head elevated for a few days but it may take months for full visual recovery from a vitreous hemorrhage.

Other times, more intensive treatment may be necessary, such as cryotherapy, laser photocoagulation, or surgery to remove the blood.