Vitreous Hemorrhage What You Need to Know

Learn the fundamentals in less than 15 minutes

What is a vitreous hemorrhage?

A vitreous hemorrhage refers to a bleed (hemorrhage) within the vitreous cavity. The vitreous cavity is located behind the natural lens of the eye and in front of the retina.

WHAT ARE THE SYMPTOMS?

FLOATERS

Patients may note new black spots that moves when the eye moves.

Red Floaters or Red Hue

Large amounts of hemorrhage may be perceived as large red objects in the vision or cast a reddish tint on light.

Blurry vision

The vision may become blurry as the blood is dispersed within the vitreous cavity. This is typically worse in the morning (more on this later).

What causes a Vitreous Hemorrhage?

There are two main causes: Β Pulling forces on retinal blood vessels and new blood vessel growth (neovascularization)

Retinal Traction

Posterior vitreous detachment – A seperation of the vitreous (gel) from the back of the eye towards the front of the eye. The gel may pull on the retinal vessels, causing a hemorrhage.

Retinal Tear with or without detachment – The vitreous may pull hard enough that it tears the retina. This may or may not be accompanied by a hemorrhage. This frequently warrants same day evaluation and treatment.

New blood vessel growth (neovascularization)

Retinal vascular diseases may cause poor blood flow to the retina. This results in the secretion of a hormone called vascular endothelial growth factor. This hormone causes the formation of abnormal blood vessels which may leak and bleed.

The most common examples include diabetic retinopathy, central retinal vein occlusion, and branch retinal vein occlusion.

Maximize Your Vision and Hasten Your Recovery

The key to the hemorrhage clearing is to allowing the blood to settle along the bottom of the eye using gravity. This will allow the blood to move away from the part of the retina responsible for central vision.

Maintain the head of the bed elevated (sleep with at least 2 pillows or in a recliner)

Avoid bending (causes the blood to disperse again)

Avoid heavy lifting or straining

Avoid high impact activities or fast eye movements (causes dispersion of the blood)

Treatment

The treatment is focused on two elements: Treating the underlying cause and improving the vision

Retinal Traction

The eye care specialist will meticulously examine the retina to evaluate for any retinal tears or detachments. Retinal tears are typically treated with an in-office laser procedure. Retinal detachments may be repaired in the office or operating room.

New Blood Vessel Growth

The eye care specialist will typically treat this condition with an in-office laser or intravitreal injections.

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