Vitreous Hemorrhage

KEY FEATURES

• Visual acuity ranges from 20/20 (6/6) to light perception only

• The eye is not inflamed, red, or painful

• Causes include

  • Retinal tears (with or without detachment)

  • Diabetic or sickle cell retinopathy

  • Retinal vein occlusion

  • Retinal vasculitis

  • Neovascular age-related macular degeneration

  • Retinal arterial macroaneurysm

  • Blood dyscrasia

  • Therapeutic anticoagulation

  • Trauma

  • Subarachnoid hemorrhage

  • Severe straining (Valsalva retinopathy)

CLINICAL FINDINGS

• Sudden visual loss

• Abrupt onset of floaters that may progressively increase in severity

• Occasionally, "bleeding within the eye"

DIAGNOSIS

• Clues to diagnosis

  • Inability to see fundus details

  • Presence of localized blood in the vitreous, in front of the retina

• In all cases, examination by an ophthalmologist is essential

TREATMENT

• Retinal tears and detachments require urgent treatment to prevent permanent vision loss