Ophthalmology » Posterior chamber » Vitreous

Vitreous haemorrhage

The common causes of vitreous haemorrhage include posterior vitreous detachment sometimes with tears of the retina, proliferative diabetic retinopathy, central or branch retinal vein occlusion, retinal arterial macroaneurysms, exudative type of senile macular degeneration. A fog suddenly appears in the visual field, impairing the vision. In the early stage floaters and flashes of light may appear. Coagulated blood (clots) may be seen as individual moving shadows in the visual field. On ophthalmoscopy, moving dark shadows are seen in the red reflex and the details of the fundus are cloudy - details might not be seen at neither the entire red reflex). Urgent consultation, same or next day, is needed if the cause of bleeding is not known.Ultrasonography is important to detect retinal detachment if the fundus is not visible. Most VH clear up spontaneously without specific treatment. The underlying cause of VH may require laser therapy, which is given as soon as the vitreous body is sufficiently clear. Laser treatment is given in proliferative retinopathy irrespective of the cause.Vitrectomy is indicated if the vitreous humour does not clear up and always promptly in case of retinal detachment.

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