What is Vitreous Haemorrhage?

The vitreous is a clear gel which is located in the middle section of the eye. It is transparent so allows light coming into the eye to pass through onto the retinal surface.

Sometimes the blood vessels in the eye can break and bleed resulting in blood flooding into the vitreous. If this happens the vitreous becomes filled with blood and is no longer clear. This can prevent the light passing through it onto the retina and causes a loss of vision in the eye.

This condition can appear quickly and painlessly, and you may experience symptoms ranging from spots or floaters in your vision to a sudden blurring of your vision, or in severe cases sudden total loss of vision can result.

Sometimes the haemorrhage will clear up without intervention over several months but if it does not treatment may be required.

It is important that you pay attention to the symptoms and that you undergo an examination so that any necessary treatment can be given.

Vitreous Haemorrhage Eye Wales

What Causes a Vitreous Haemorrhage?

The vitreous cavity of a healthy eye is filled with nothing other than clear vitreous gel. Bleeding into the vitreous can be from either normal blood vessels or from abnormal blood vessels which have grown on the retina. The most common cause of vitreous haemorrhage is due to proliferative diabetic retinopathy. Other causes may be due blockage of a retinal vein, trauma to the eye or a retinal tear.

The natural ageing process causes the vitreous to shrink away from the back of the eye over time this is called a posterior vitreous detachment (PVD). As the vitreous leaves the retina it can pluck on a blood vessel causing blood to be released into the vitreous. In this process the vitreous can also cause a tear in the retina which is extremely dangerous and can result in a retinal detachment. It is therefore imperative to seek medical attention as soon as possible to exclude this. 

Abnormal blood vessels can develop on the surface of the retina because of underlying problems with the retina. Uncontrolled diabetic retinopathy causes the retina to develop new abnormal blood vessels which can result in bleeding and a vitreous haemorrhage.

Retinal vein occlusion can cause a blockage in the retinal vein or of one of its branches. This causes the retina to develop abnormal and fragile blood vessels which often bleed into the vitreous.

How would a Vitreous Haemorrhage Affect my Sight?

Vitreous haemorrhage causes a broad range of visual symptoms, varying from quite mild to severe.

You may experience floaters in your vision. These may appear as small shapes you notice floating about in your vision, they may be more noticeable if you’re looking against a clear background. They may look like blots of ink in your vision which then coalesce to form a general haze. 

You may experience a quite profound visual loss, such that you could not detect movement that is quite close to your face.

You could find that your vision tends to be worse in the morning, as the blood has settled to the bottom of the eye during the night.

When should I have Surgery for a Vitreous Haemorrhage?

The type of treatment we would recommend for a vitreous haemorrhage depends on what has caused the condition.

In some cases, where the vitreous haemorrhage is mild, no treatment is required and the eye will naturally heal itself. In these cases observation is advised whilst the vitreous haemorrhage is reabsorbed by the eye.

The health and integrity of the retina needs to be established in cases where the vitreous haemorrhage is severe and no view of the retina is possible. An ultrasound scan of the eye is then performed to check on the retinal health and structure.

The definitive way of removing a vitreous haemorrhage effectively is with an operation called a vitrectomy. This involves keyhole surgery in the eye to remove the vitreous haemorrhage and assess the cause for it. The surgical removal of the vitreous especially in the case of vitreous haemorrhage has meant a once blinding eye condition can now be successfully treated with surgery. In cases of diabetic eye disease a vitrectomy is often combined with internal laser treatment as part of the operation to treat diabetic retinal disease. At the end of the operation either an air or gas bubble is injected to replace the vitreous which has been removed. This is performed as a day case and postoperative drops are given for a month after surgery.

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