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    Viterous Hemmorage

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    Kishan S Gowda
    This document discusses vitreous hemorrhage, which occurs when blood leaks into the gel-like vitreous humor located in the middle of the eye. Vitreous hemorrhage can be caused by conditions that rupture blood vessels in the eye like retinal tears, trauma, inflammation, and vascular or metabolic disorders like diabetes. Symptoms include floaters or sudden vision loss. Signs include observing blood in the vitreous cavity during examination. Treatment may include resting the eye, treating the underlying cause, or vitrectomy surgery to clear blood from the vitreous if it does not absorb on its own after 3 months.

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    Viterous Hemmorage

    Uploaded by

    Kishan S Gowda
    28 views11 pages
    This document discusses vitreous hemorrhage, which occurs when blood leaks into the gel-like vitreous humor located in the middle of the eye. Vitreous hemorrhage can be caused by conditions that rupture blood vessels in the eye like retinal tears, trauma, inflammation, and vascular or metabolic disorders like diabetes. Symptoms include floaters or sudden vision loss. Signs include observing blood in the vitreous cavity during examination. Treatment may include resting the eye, treating the underlying cause, or vitrectomy surgery to clear blood from the vitreous if it does not absorb on its own after 3 months.

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    This document discusses vitreous hemorrhage, which occurs when blood leaks into the gel-like vitreous humor located in the middle of the eye. Vitreous hemorrhage can be caused by conditions that rupture blood vessels in the eye like retinal tears, trauma, inflammation, and vascular or metabolic disorders like diabetes. Symptoms include floaters or sudden vision loss. Signs include observing blood in the vitreous cavity during examination. Treatment may include resting the eye, treating the underlying cause, or vitrectomy surgery to clear blood from the vitreous if it does not absorb on its own after 3 months.

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    28 views11 pages

    Viterous Hemmorage

    Uploaded by

    Kishan S Gowda
    This document discusses vitreous hemorrhage, which occurs when blood leaks into the gel-like vitreous humor located in the middle of the eye. Vitreous hemorrhage can be caused by conditions that rupture blood vessels in the eye like retinal tears, trauma, inflammation, and vascular or metabolic disorders like diabetes. Symptoms include floaters or sudden vision loss. Signs include observing blood in the vitreous cavity during examination. Treatment may include resting the eye, treating the underlying cause, or vitrectomy surgery to clear blood from the vitreous if it does not absorb on its own after 3 months.

    Copyright:

    © All Rights Reserved
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    of 11

    VITREOUS HEMORRHAGE 

    MADAN SN 
    53
    VITREOUS HAEMORRHAGE                       
            

     Vitreous  haemorrhage usually occurs from the retinal vessels and may


    present as pre retinal(sub-hyaloid) or an intragel  haemorrhage.
    The intragel  hemorrhage may involve anterior, middle, posterior or the
    whole vitreous body 
    Causes 
    1. Retinal tear, PVD and RD may have associated vitreous haemorrhage                  
    2. Trauma to eye, which may be blunc or perforating (with or without   retanied intraocular
    foreign body) in nature                                                              
    3. Inflammatory diseases such as erosion of the vessels in acute chorioretinitis and
    periphlebitis retinae primary (Eales' disease), or secondary to uveitis                          
    4. Vascular disorders, e.g. hypertensive retinopathy, cenrral retinal vein occlusion (CRVO)
    and, branch retinal vein occlusion (BRVO).                                                       
    5. Metabolic diseases such as diabetic retinopathy.
    .

    6. Exudative age-related macular degeneration usually high CNVM, may have vitreous
    haemorrhage                                                                                                  
    7.Blood dyscrasias, e.g. retinopathy of anaemia, leukaemias, polycythemias and sickle-cell
    retinopathy.                                                                                                 
    8. Bleeding disorders, e.g. purpura, haemophilia and scurvy.                                     
    9. Neoplasms. Vitreous haemorrhage may occur from rupture of vessels due to acute necrosis in
    tumours like retinoblastoma and malignant melanoma of choroid.  
    10. Other causes include Coat's diseases, radiation retinopathy, retinal capillary aneurysm,
    retinal macroaneurysm terson syndrome.
    Clinical features
    Depending upon the location it is labeled as:                                                                 
    • Anterior vitreous haemorrhage,                                                                               
    • Mid vitreous haemorrhage,                                                                                     
    • Posterior vitreous haemorrhage, or                                                                        
    • Total vitreous haemorrhage
    Symptoms
    • Floaters of sudden onset occur when the vitreous haemorrhage is small               
    • Sudden painless loss of vision occurs in large vitreous haemorrhage. 
    Signs
    • Distant direct ophthalmoscopy reveals black shadows against the red glow in small
    haemorrhages and no red glow in a large haemorrhage.                                   
    • Direct and indirect ophthalmoscopy may show presence of blood in the vitreous cavity in
    small  vitreous haemorrhage and non-visualization of fundus in large  vitreous haemorrhage.       
                                           
    • Slit-lamp examination shows normal anterior segment and a reddish mass in the vitreous.       
                                                             
    • Ultrasonography with B-scan is particularly helpful in diagnosing vitreous haemorrhage.
    Fate of vitreous haemorrhage
     l. Complete absorption may occur without organization and the vitreous becomes clear within
    4-8 weeks.                                                                                               
    2. Organization of haemorrhage with formation of a yellowish-white debris occurs in persistent
    or recurrent bleeding.                                                                               
    3. Complications like vitreous liquefaction, degeneration and khaki cell glaucoma (in aphakia)
    may occur.                                                                                                 
     4. Retinitis proliferans may occur which may be complicated by tractional retinal detachment. 
    Treatment 
    I. Conservative treatment consists of bed rest and elevation of patient's head. This will allow
    the blood to settle down. Most of the time conservative treatment is sufficient. 

    II. Treatment of the cause. Once the blood settles down, indirect ophthalmoscopy should be
    performed to locate and further manage the causative lesion such as a retinal break,
    phlebitis, proliferative retinopathy, etc.                                                  
    III.  Vitrectomy by pars plana route should be considered to clear the vitreous, if the
    haemorrhage is not absorbed after 3 months. Early vitrectomy may be required when
    associated with retinal detachment. 
    Reference

    Comprehensive opthalmology, A K Khurana


    .

    THANK YOU

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