Vitreous hemorrhage is an urgent medical situation involving bleeding into the vitreous humor, the clear, gel-like substance filling the eye’s main cavity. Prompt medical attention is important to determine the cause and preserve vision.
Understanding Vitreous Hemorrhage
The vitreous humor is a transparent, gel-like substance between the lens and retina, occupying about 80% of the eye’s volume. Its clarity is essential for light to reach the light-sensitive retina. When blood enters this clear space, it obstructs light, impairing vision. Vision loss severity depends on the blood’s amount and density.
Recognizing the Symptoms
Symptoms are typically sudden and painless. New floaters (small specks, cobweb-like shapes, or shadowy forms) may drift across the field of vision. Blurred vision, a hazy appearance, or a sudden decrease in vision can occur. A reddish tint to vision or flashes of light might also be experienced. Visual disturbance may be worse in the morning as blood settles overnight.
Common Causes
Vitreous hemorrhage results from various underlying conditions, with diabetic retinopathy (where fragile blood vessels form on the retina) being a frequent cause. Retinal tears or detachments can also cause bleeding if vessels are damaged. Posterior vitreous detachment (PVD), a natural aging process where the vitreous gel pulls away from the retina, sometimes causes a tear and bleeding. Trauma, such as blunt impact, is common, particularly in younger individuals. Other causes include retinal vein occlusion, vascular malformations like retinal macroaneurysms, and in rare cases, eye tumors or inflammation.
What to Do Immediately
If you experience sudden vision changes, seek immediate medical evaluation, as it can indicate a serious underlying condition. Contact an eye care professional (optometrist or ophthalmologist) or an emergency room promptly. Delaying assessment and treatment can lead to significant, potentially permanent vision loss, especially if retinal detachment is present. Avoid self-treating or waiting for symptoms to resolve, as professional diagnosis is necessary to identify the cause and determine the appropriate course of action. A thorough eye examination assesses internal structures and initiates suitable management.
Treatment Approaches and Outlook
Diagnosis typically involves a comprehensive eye exam, including a dilated fundus exam to view the retina. If blood obscures the view, an eye ultrasound can provide images of internal structures and help detect retinal detachment. Treatment depends on the cause and severity. For minor hemorrhages, observation may suffice, as blood can reabsorb over weeks to months.
For significant or persistent bleeding, or if an underlying issue is found, various interventions may be considered. Laser photocoagulation can seal leaking blood vessels or treat retinal tears. Anti-VEGF injections help manage abnormal blood vessel growth, particularly in diabetic retinopathy or age-related macular degeneration.
If the hemorrhage is dense, does not clear, or is associated with a retinal detachment, a surgical procedure called vitrectomy may be performed. This involves removing the blood-filled vitreous gel, replacing it with a clear solution or gas. The visual outlook varies; with timely treatment, vision often improves, but prognosis is influenced by the underlying cause and its response to therapy.