A vitreous bleed which is what happens when blood gets into the eye’s clear gel like material which in turn causes vision to become cloudy or dark. What treatment for vitreous hemorrhage treatment is right depends on the cause of the bleed, the amount of blood that has been collected and if the retina is affected. Sudden vision loss is a reason to seek urgent medical care even if there is no pain.
What Causes Vitreous Hemorrhage?
The vitreous which is a part of the eye’s structure, transmits light to the retina the light sensitive cell layer at the back of the eye. In case of bleeding it will interrupt vision. An bleeding in eye retina problem may extend into the vitreous in which case it is dependent on the base health issue.
Common causes include:
- Diabetic retinopathy: Damaged retinal blood vessels may produce a poor quality repair which bleeds.
- Retinal tears or detachment: A blood vessel may have a tear which in turn may cause blood to get in the vitreous.
- Eye injury: Blunt or serious trauma causes internal bleeding.
- Age-related changes: The retina may also separate from the vitreous at times which in turn causes tears.
A diabetic vitreous hemorrhage is a serious issue which reports that in the case of late stage diabetic eye disease which see repeat bleeding which in turn may lead to loss of sight if not treated. Also for people with diabetes it is important they adhere to regular retinal screenings and work with their health care team to manage blood sugar and blood pressure.
What Symptoms Should Not Be Ignored?
Vitreous hemorrhage symptoms present very suddenly and are very variable, from mild floaters to total loss of vision. Some report a general haziness, cobweck like structures or dark moving spots in their field of vision. Also it may present as a red tint or a shadow which in turn makes reading and other daily tasks a challenge.
| Symptom | What it may feel like |
| Floaters | Dark dots, threads or cobweb-like shapes |
| Blurred vision | Hazy or cloudy sight |
| Dark shadow | A patch or curtain across the field of vision |
| Sudden reduced vision | Vision becoming dim or severely limited |
In ophthalmology Vasan Eye Care uses the term blood in vitreous to describe blood within the eye’s gel, also it is important to note that symptoms alone are not sufficient for a diagnosis. New flashes of light, a large increase in floaters, a curtain like shadow or sudden vision loss may point to retinal tear or detachment. Seek out urgent eye care instead of waiting for symptoms to settle.
How Is Vitreous Hemorrhage Diagnosed?
An ophthalmologist will have the patient undergo an eye exam and ask at what point the symptoms started, if there was any eye injury and also what preexisting conditions like diabetes are present. A dilated retinal exam is performed which helps to identify any bleeding and also possible retinal damage.
If retinal blockage is present at the eye exam which may use ultrasound to look at the back of the eye and also check for retinal detachment. Also they may recommend other tests as they are needed. In the case of Glaucoma pressure readings evaluation during the eye assessment which is at the doctor’s discretion, also it is to be noted that pressure measures alone do not diagnose vitreous hemorrhage.
The results guide vitreous hemorrhage treatment which may include observation, laser therapy, injection or surgery.
What Treatment Options Are Available?
Treatment is based on the cause and degree of bleeding. In some instances the blood will slowly clear without a procedure. While this may happen the base issue still needs to be determined and managed in to reduce risk of more bleeding.
| Treatment option | When it may be considered |
| Observation | When the bleeding is limited and the retina is stable |
| Anti-VEGF injections | For selected cases involving abnormal retinal blood vessels |
| Laser treatment | To treat abnormal vessels or suitable retinal problems |
| Vitrectomy surgery | When blood does not clear, vision is severely affected or retinal complications require surgery |
The best course of action for vitreous hemorrhage treatment is based on what is found during the exam and not just the symptoms. Vasan eye care may use an injection to stop abnormal growth of blood vessels, also which use laser treatment to reduce the risk of more bleeding in which it is appropriate.
In some cases of surgery which are necessary, which perform a vitrectomy that removes the blood filled vitreous which in turn allows the surgeon to look at and repair the retina. Recovery time is a variable which depends on what caused the issue in the first place, the health of the retina and also what other procedures may have been done. Also it is important to have follow up visits even after you begin to see your vision improve.
In patients which have developed the more serious stage of diabetic retinal disease that is known as proliferative diabetic retinopathy which in turn helps to explain the growth of weak new blood vessels which may bleed. In some cases vitreous haemorrhage treatment will include injections, laser therapy or surgery which will be determined by what the retina shows.
Can Vitreous Hemorrhage Be Prevented?
Not all episodes can be avoided but they do see results in the management of some health issues which in turn reduces risk. For people with diabetes it is important to attend as per the recommended retinal exams even if your vision is fine. Also by keeping blood sugar and blood pressure at target which may see to it that we reduce more retinal damage.
A bleeding in eye retina should not be treated with home remedies or unsupervised eye drops. If you see new floaters or have blurred vision seek immediate medical attention. Vitreous hemorrhage symptoms may also present like other retinal issues which is why an exam is required to determine the cause.
People who have recurring or persistent blood in vitreous should have follow up as directed by an ophthalmologist. Timely evaluation can determine if there are complications and also if further vitreous hemorrhage treatment is required.
Eye Care at Vasan Eye Care
Vasan Eye Care which provides retinal assessment and also treats a variety of retinal and vitreous conditions. What Vasan Eye Care does is based on the diagnosis which may range from close monitoring to in office injections, laser procedures, or in some cases retinal surgery. Tailor our treatment plan to the patient’s specific eye health which in turn is based on what is thought is the cause of the bleed.
Patients also have the option to learn what proliferative diabetic retinopathy is and what retinal services are available which in turn will help them understand the relationship between diabetes and sight threatening complications. In some cases vitreous haemorrhage treatment may require surgery when the blood doesn’t go away on its own or when retinal complications are present.
Eye bank refers to the practice of donation, collection and supply of eye tissue for transplant. This is in contrast to retinal services which are used for diagnosis and management of bleeding inside the eye.
Conclusion
Vitreous hemorrhage which may present as floaters or all of a sudden very serious vision loss. Early recognition of changes and prompt ophthalmic care is key in determining the cause and in preserving what vision is left. A specialist will put forth the best vitreous hemorrhage treatment option after they have had a chance to study the retina and determine the extent of the bleed.
For more information see the National Eye Institute’s patient info on diabetic retinopathy and vitrectomy.
Frequently Asked Questions
1. Does vitreous hemorrhage always require surgery?
No. In mild cases as the blood reabsorbs naturally improvement may be seen provided the retina is stable and the base cause is treated. For surgery which may turn to when bleeding is continuous, vision is very poor or a retinal tear or detachment needs repair.
2. How long does vitreous hemorrhage take to clear?
The degree of time involved varies by the amount of blood and the cause. In some cases improvement is seen in a few weeks, for others which are more severe or repeat bleeds it may take months or may not even see resolution without treatment. Regular follow up is key to monitor progress also which also helps in early detection of any complications.
3. Is a diabetic vitreous hemorrhage an emergency?
A timely evaluation is required for diabetic vitreous hemorrhage which may present with acute change in vision. New bleed is a feature of advanced diabetic retinopathy or other retinal complications. Sudden loss of vision, flashes or a curtain like shadow requires prompt ophthalmic care.
4. Can vision return after treatment?
Vision improves when the blood does improve and retina health is present. As for recovery, that does not always happen in cases where the macula or other retinal structures are affected. For Vitreous hemorrhage treatment, options are there to treat the bleed or it’s cause but please note this will not always see full vision return.
References Links
- National Eye Institute — Diabetic Retinopathy
https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/diabetic-retinopathy