Vitreous Hemorrhage

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KEY POINTS

• Vitreous is the clear gel in the center of your eyeball. Blood leaking into this gel is called a vitreous hemorrhage.
• Once the cause of the bleeding is known, it may be treated with surgery, laser treatment, or cryotherapy.

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What is vitreous hemorrhage?

Vitreous is the clear gel in the center of your eyeball. Normally the vitreous is clear, and light passes through it to your retina. The retina is the lining at the back of the eye that senses light coming into the eye. Blood leaking into the vitreous is called a vitreous hemorrhage.

What is the cause?

Any condition that causes bleeding in your eye can allow blood to leak into the vitreous. Possible causes include:

• Diabetic retinopathy, which is new, abnormal blood vessels that form in the back of the eyes of people with diabetes. These blood vessels are not strong and can bleed.
• Injuries from car accidents, sports, falls, or being punched or kicked in your eye
• Posterior vitreous detachment, which is the clear gel that fills the center of the eye getting more liquid. As the gel turns more liquid it can pull on the retina and cause tears and bleeding.
• Bleeding in the brain
• Blood vessels in your eyes that become narrow, blocked, or weak
• Sickle cell disease, which can cause blood clots to form and abnormal blood vessels to grow in the back of your eyes. These blood vessels are not strong and can bleed.

What are the symptoms?

The two most common symptoms are blurry vision and floaters, which are black spots or cobweb-like shapes. You may notice a reddish tint to your vision. You may also notice bright flashes of light in the corners of your vision. This is caused by the vitreous gel pulling on the retina, which can sometimes lead to a retinal tear. These symptoms are painless and may come on suddenly.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and do exams and tests such as:

• An exam using a microscope with a light attached, called a slit lamp, to look closely at the front and back of your eye
• An exam using drops to enlarge, or dilate, your pupils and a light to look into the back of your eyes
• An ultrasound, which uses sound waves to show pictures of your eye
• Blood tests to look for causes of bleeding
• CT scan, which uses X-rays and a computer to show detailed pictures of the bones and tissues around your eye if your eye has been injured
• You may be referred to a retinal specialist. You may be asked to sleep with a few pillows behind your head to help the blood settle down. Ask your healthcare provider if you need to avoid taking any medicine or supplements.

How is it treated?

Treatment depends on the cause.

Once the cause of the bleeding is known, it can be treated in a number of ways, such as surgery to stop the bleeding or to remove the blood, laser treatment, or cryotherapy, which is freezing treatment to part of your eye. The vitreous hemorrhage can take months to go away even after the bleeding has stopped. You may keep having symptoms until all of the blood is gone.

How can I take care of myself?

Follow the full course of treatment your healthcare provider prescribes. Sleeping with your head up on extra pillows helps the blood settle.

Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent vitreous hemorrhage?

• To help prevent severe eye injuries, wear safety eyewear when you:
  • Do any work around the house that requires hammering, power tools, chemicals, or splatter of any kind
  • Play paintball, racquetball, lacrosse, hockey, and fast-pitch softball
  • Shoot firearms or use explosives of any kind
  • Are in a high-risk area such as a construction site or shooting range
• Have regular eye exams, especially if you have a health condition such as diabetes or sickle cell disease.
• If you have diabetes, it is very important to keep good control of your blood glucose, your blood pressure, and your cholesterol.