A vitreous hemorrhage occurs when a blood vessel ruptures and bleeds within or near the vitreous cavity of the eye. Ordinarily, there are no blood vessels located within the vitreous cavity, only vitreous fluid, a gel-like substance that helps maintain the eye’s round shape. However, complications from diseases or other eye conditions can cause a vitreous hemorrhage to occur.
Vitreous hemorrhages are caused by three primary sources:
Abnormal blood vessels: Particularly common for those with a history of diabetic retinopathy, in addition to other retinal conditions such as retinal vein occlusion. These retinal conditions cause the growth of new, abnormal blood vessels. When ruptured, these fragile blood vessels cause bleeding within the vitreous cavity.
Rupture of normal blood vessels:Normal blood vessels can rupture and bleed as a result of trauma from an eye injury or from a break in the retinal layer such as in the case ofretinal detachment or a retinal tear .
Blood from an adjacent source: Bleeding from sources near to the vitreous cavity can also lead to complications when blood leaks into the vitreous. Adjacent bleeding could be caused by sources such as tumours, retinal arterial macroaneurysms, and the wet form of age-related macular degeneration.
Symptoms of Vitreous Hemorrhage
The symptoms of vitreous hemorrhages are varied, given the wide range of related eye conditions that may be the underlying cause of this condition. In addition, the symptoms of a vitreous haemorrhage are usually painless.
Symptoms of a vitreous hemorrhage include:
- Appearance of floaters, which appear like small dots or fine particles of hair in your field of vision.
- Cloudy or hazy vision
- Shadows, cobwebs, or red hue appearing in your vision
- Minor to severe vision loss depending on the severity of the vitreous haemorrhage. Some patients describe vision loss as being worse in the morning as blood within the vitreous settles to the back of the eye during sleep.
Causes of Vitreous Hemorrhage
Complications caused by diabetic retinopathyare what most often lead to the formation of abnormal blood vessels, and, subsequently, vitreous hemorrhages when these blood vessels rupture and bleed into the vitreous.
Other causes of vitreous hemorrhage or bleeding into the vitreous include:
- Retinal vein occlusion
- Eye injury
- Retinal detachment or retinal tears
- Intraocular tumours
- Retinal arterial macroaneurysm
- Wet form of age-related macular degeneration
- Diabetic retinopathy
Given the wide range of eye diseases and conditions that can lead to vitreous hemorrhage, prompt evaluation is needed to determine the status of the retina and what treatment is appropriate based on the underlying cause.
Diagnosing Vitreous Hemorrhage
Vitreous hemorrhage can be diagnosed through an eye exam while determining the cause of the vitreous hemorrhage requires a review of your medical history and possibly other tests in order to identify where the bleeding into the vitreous originates from.
B-scan ultrasound may be needed if your retinal specialist does not have a clear view to the back of the eye during examination. This can be performed at your visit to Calgary Retina Consultants. Blood tests may also be required to determine if the vitreous haemorrhage is being caused by diabetes.
Calgary Retina Consultants has access to some of the most advanced diagnostic facilities in Western Canada. Your retinal specialist will isolate the cause of the vitreous haemorrhage and ensure that you receive the necessary treatment.
Treatment of Vitreous Hemorrhages
The appropriate treatment for vitreous hemorrhages depends on the source of the bleeding as well as any other eye conditions that need to be addressed.
Laser treatment, eye injections, and / or surgery may be required. Laser and injections such as Avastin, Lucentis, and Eylea, can cause regression of the abnormal blood vessels. If the hemorrhage is too close, surgery (vitrectomy) may be required to clear the hemorrhage and treat the underlying problem