Summary about Disease
Vitreous hemorrhage (VH) is the extravasation and leakage of blood into the vitreous humor, the clear, gel-like substance that fills the space between the lens and the retina in the eye. This bleeding can obstruct vision, ranging from mild floaters to complete loss of sight, depending on the severity and location of the hemorrhage. It is not a disease itself but rather a complication of other underlying conditions.
Symptoms
Sudden onset of blurred vision
Floaters (spots, cobwebs, or strands floating in your vision)
Hazy or smoky vision
Partial or complete loss of vision
Reddish tint to vision (less common)
Sensitivity to light
Causes
Diabetic Retinopathy: The most common cause, where damaged blood vessels in the retina leak.
Posterior Vitreous Detachment (PVD): Separation of the vitreous gel from the retina, sometimes tearing a blood vessel.
Retinal Tears or Detachment: Can cause bleeding into the vitreous.
Age-Related Macular Degeneration (AMD): Especially the wet form, involving abnormal blood vessel growth.
Trauma: Injury to the eye.
Vitreous or Retinal Neovascularization: Abnormal blood vessel growth due to other conditions.
Blood vessel blockage: Central or Branch Retinal Vein Occlusion
Less Common Causes: Blood disorders (e.g., leukemia, sickle cell disease), eye surgery complications, Terson syndrome (associated with subarachnoid hemorrhage)
Medicine Used
There is no specific medicine to directly treat a vitreous hemorrhage itself. Treatment focuses on addressing the underlying cause. However, sometimes the following are used.
Anti-VEGF injections: Medications like bevacizumab, ranibizumab, or aflibercept, which may be used to treat underlying conditions like diabetic retinopathy or wet AMD that can cause the hemorrhage.
Steroids: Used in some cases to reduce inflammation, but not a primary treatment.
Eye drops: Used to dilate the pupil for better examination of the retina.
Is Communicable
No, vitreous hemorrhage is not communicable (not contagious). It is a result of underlying eye conditions or injuries and cannot be spread from person to person.
Precautions
Precautions depend on the underlying cause and are geared towards preventing future hemorrhages. Common recommendations include:
Strict control of blood sugar levels (for diabetic patients).
Regular eye exams, especially for people with diabetes, high blood pressure, or a family history of eye disease.
Protective eyewear during sports or activities with a risk of eye injury.
Avoiding medications that could increase bleeding risk (discuss with your doctor).
Prompt medical attention if you experience sudden vision changes.
How long does an outbreak last?
A vitreous hemorrhage itself is not an "outbreak," but an isolated event. The duration of vision impairment depends on the severity of the bleed and how long it takes for the blood to clear. Mild hemorrhages may clear within weeks to months, while severe hemorrhages can take many months or even years to resolve spontaneously. Treatment can shorten the recovery time.
How is it diagnosed?
Dilated Eye Exam: An ophthalmologist dilates the pupils to examine the retina and vitreous.
Slit-Lamp Examination: Uses a high-intensity light to view the structures of the eye.
Optical Coherence Tomography (OCT): Imaging test that provides cross-sectional images of the retina.
Ultrasound: Used if the view of the retina is obscured by dense blood.
Fluorescein Angiography: Dye is injected into a vein, and pictures of the retinal blood vessels are taken to identify abnormalities.
Timeline of Symptoms
Sudden Onset: Symptoms typically appear suddenly.
Initial Stage: Blurred vision, floaters, hazy vision.
Progression: Vision may worsen over hours or days as more blood accumulates.
Stabilization: The hemorrhage may stabilize, with vision remaining constant until the blood clears or treatment is initiated.
Resolution: Gradual improvement in vision as the blood is absorbed, which can take weeks, months or longer.
Important Considerations
Prompt Medical Attention: Seek immediate ophthalmological evaluation if you experience sudden vision changes.
Underlying Cause: Identifying and treating the underlying cause is crucial to prevent further hemorrhages.
Multiple Treatment Options: Treatment options vary depending on the cause and severity of the hemorrhage and may include observation, laser photocoagulation, anti-VEGF injections, or vitrectomy surgery.
Potential Complications: Untreated vitreous hemorrhage can lead to vision loss, retinal detachment, or other serious eye complications.
Individual Variation: The recovery time and visual outcome can vary significantly from person to person.