Vitreous Hemorrhage

Vitreous Hemorrhage

What is Vitreous Haemorrhage?
Vitreous haemorrhage occurs when blood leaks into the vitreous humour inside the eye. The leaked blood most commonly comes from blood vessels at the back of the eye. This is more likely to happen if the blood vessels have been damaged (by trauma) or are particularly fragile (because of eye disease related to diabetes).

How common is vitreous haemorrhage?
Vitreous haemorrhage affects about 7 per 100,000 people each year. This makes it one of the most common causes of sudden deterioration in vision. It most often affects only one eye.

Who is likely to experience vitreous haemorrhage?
The most common cause of vitreous haemorrhage is severe diabetic eye disease.The other common causes of vitreous haemorrhage also tend to occur in adults aged 60 and above, except for eye trauma, which can occur at any age.Causes includes posterior vitreous detachment, retinal tears and detachments, tumours, foreign objects, Macular degeneration,Retinal vein occlusion, Retinopathy with sickle cell disease.

What are the symptoms of vitreous haemorrhage?
The symptoms of smaller bleeds are floaters, cobwebs, haze and shadows in the eye. There may be a red tint to the vision. More severe bleeds cause haziness of vision, sometimes with blind spots or dark streaks.The most severe bleeds cause visual loss, which can be complete, leaving the vision hazily red or black.

How is vitreous haemorrhage diagnosed?
VH can be diagnosed by Comprehensive ophthalmic examination including Silt lamp exam and Indirect Ophthalmoscopy. Imaging technologies such as Ultrasound and Fundus fluorescein Angiography.

What is the treatment for vitreous haemorrhage?
The treatment of vitreous haemorrhage varies with the cause. Aims of treatment are to:
• Find the source of the bleeding.
• Stop the bleeding.
• Repair any damage to the retina before it results in permanent loss of vision.
• Restore normal vision.

Once the source of the bleeding has been identified, treatment will depend on the cause. If there is not too much blood in the vitreous and the source of bleeding can be seen then it is treated. This means laser treatment to bleeding vessels and any other abnormal vessels, and repair to any tears in the retina. After this it is a matter of waiting for the blood to slowly clear. This can take several weeks.

You will be advised to avoid strenuous activity for several days at least, as this might dislodge clots and trigger new bleeding. You are also advised to sleep with the head of your bed elevated, as this allows the blood in the vitreous to settle into the bottom of the eye, out of the line of vision. If the blood in the vitreous obscures the view and prevents treatment of the bleeding then the entire vitreous may be removed first. This procedure is called a vitrectomy. Doctors will perform a vitrectomy if they can't see the back of the eye, or if the view isn't good enough to treat the bleeding there safely.

Laser photocoagulation is the usual treatment for fragile abnormal vessels. Treating them both stops the bleeding and prevents later bleeding. Laser photocoagulation is also used in repairing damage to the retina.

Anti-VEGF injections aim to shrink abnormal new vessels which have formed in the eye. They are sometimes used in patients with diabetes, in addition to other treatments like laser photocoagulation and vitrectomy, in order to reduce bleeding.

Vitrectomy is removal of the vitreous humour completely, together with the membrane that surrounds it. This is done when there is so much blood in the vitreous that it is impossible to diagnose and treat the cause. Vitrectomy is also sometimes performed if the blood in the vitreous is clearing very slowly and vision remains impaired.

Synergy Eye Care is well equipped and its doctors are well experienced in treating this disease using required procedures and /or surgeries with good results.


Disclaimer: Information published here is for educational purposes only and is not intended to replace medical advice. If you suspect that you have a health problem, please consult your doctor immediately

FUNDUS PICTURE OF VITREOUS HAEMORRHAGE

Expert Doctors

Dr. Vinay Garodia

Founder Director

MBBS (AIIMS), MD (AIIMS, Gold Medalist) DNB,
MNAMS, FRCS (Eng)

Vitreoretina, Cataract and Refractive