Blood in the eyeball (vitreous hemorrhage)

[ad_1]

What is it about ?

The eyeball contains a transparent gel, the vitreous, which fills most of the eye and is located behind the lens. Light rays pass through this gel to reach the retina at the back of the eye. This is how we can save images. If there is blood in the vitreous, it is called vitreous hemorrhage.

The most common causes are:

  • a vitreous detachment, with or without retinal tear. This is because the vitreous body shrinks with age and its composition changes. The vitreous can then detach from the retina, peel off. This can be associated with the bursting of a small blood vessel, with infiltration of blood into the vitreous.
  • the diabetes may be responsible for a decrease in blood and oxygen supply to the retina. New blood vessels then appear between the retina and the vitreous (proliferative diabetic retinopathy). These new blood vessels are very fragile and of poor quality and can therefore easily bleed into the retina and vitreous.
  • As a result of a blockage in a blood vessel, the retina receives too little blood or oxygen. In this case too, new fragile blood vessels appear which can bleed. Blockage of an eye blood vessel can be caused by a clot (thrombosis) or a inflammation (vasculitis).
  • Bleeding from the vitreous may also be due to eye trauma caused by a sharp or blunt object.

Where and how often?

Each year, about 7 in 100,000 people have a vitreous hemorrhage. The average age of patients is 60 years.

How to recognize it?

In the event of vitreous hemorrhage, vision is suddenly blurred by a haze or fog. The fog moves as the head / eye moves. There is no pain.

At first, floating dots resembling small spots or flashes of light may appear. Clouding caused by inflammation occurs more slowly. The vision loss depends on the extent of the bleeding. Heavy vitreous bleeding can limit vision to such an extent that the person can only see light.

How is the diagnosis made?

If vitreous bleeding occurs, the outward appearance of the eye is normal. However, it is not possible to do a normal examination of the inside of the eye; blood in the eye prevents the person from seeing well, and the ophthalmologist cannot examine the inside of the eye properly.

What can you do ?

In case of vitreous hemorrhage, it is better to elevate your head or be in a sitting position to sleep. Blood collects in the back of the eye, which speeds up recovery of vision.

What can the doctor do?

Treatment depends on the results of the examination performed by the ophthalmologist. In some cases, it is advisable to wait cautiously for healing. The opacification of the vitreous disappears largely spontaneously within a few days to a few weeks or a few months depending on the extent of the bleeding.

If there is no known disease that may be causing the vitreous bleeding, you should urgently see an ophthalmologist, who will look for the cause. In case of trauma or injury, it should be seen by an ophthalmologist immediately, and in other cases, preferably the same day or the next day. In some cases, the ophthalmologist will have to perform a ultrasound to check if there is a retinal detachment.

If the eye has already been treated with laser, it is better to contact the ophthalmologist who took care of it so that he can perform additional examinations and prescribe treatment. If new (fragile) blood vessels have formed in the eye, they will be treated with a laser to stop the bleeding or to prevent further bleeding. Laser treatment is also used for torn retina and retinal detachment.

If the clouding of the vitreous persists or if a re-application of the retina is needed, an operation called a vitrectomy is done to remove the blood. The vitreous is then replaced by another liquid.

Want to know more?

Source

Foreign clinical practice guide ‘Vitreous hemorrhage (HV)’ (2000), updated on 04.09.2017 and adapted to the Belgian context on 28.12.2019 – ebpracticenet

[ad_2]

Latest