Vitreous Haemorrhage

Question 1

What is vitreous haemorrhage?

Answer 1

This is bleeding into the vitreous humour.
It is one of the most common causes of sudden painless loss of vision

It causes disruption to vision to a variable degree, ranging from floaters to complete visual loss.

Question 2

What are the causes of vitreous haemorrhage?

Answer 2

Proliferative diabetic retinopathy
Posterior vitreous detachment
Ocular trauma: most common cause in children and young adults

Question 3

What do patients with vitreous haemorrhage present with?

Answer 3

painless visual loss or haze (commonest)
red hue in the vision
floaters or shadows/dark spots in the vision
Either acute or subacute

Question 4

What are the signs of vitreous haemorrhage?

Answer 4

Signs:
decreased visual acuity: variable depending on the location, size and degree of vitreous haemorrhage
visual field defect if severe haemorrhage

Question 5

What investigations are done for vitreous haemorrhage?

Answer 5

dilated fundoscopy: may show haemorrhage in the vitreous cavity
slit-lamp examination: red blood cells in the anterior vitreous
ultrasound: useful to rule out retinal tear/detachment and if haemorrhage obscures the retina
fluorescein angiography: to identify neovascularization
orbital CT: used if open globe injury