Vitreous Haemorrhage

Question 1

What is a Vitreous Haemorrhage?

Answer 1

Bleeding into the vitreous humour.

Question 2

Presentation of Vitreous Haemorrhage.

Answer 2

1. One of the commonest causes of sudden painless loss of vision.
2. Disruption varies from floaters to complete visual loss.

Question 3

Clinical Features of Vitreous Haemorrhage (4).

Answer 3

Acute/Sub-Acute Onset of :

1. Painless Visual Loss / Haze (commonest);
2. Red Hue in Vision.
3. Reduced Visual Acuity.
4. Small - Floaters; Moderate - Numerous Dark Spots; Large - Sudden Visual Loss.

Question 4

Aetiology of Vitreous Haemorrhage (5).

Answer 4

90% :
1. Proliferative Diabetic Neuropathy (>50%).
2. Posterior Vitreous Detachment.
3. Ocular Trauma (Kids, Young Adults)
A. Bleeding Disorders.
B. Anticoagulant Use.

Question 5

Pathophysiology of Vitreous Haemorrhage (2).

Answer 5

1. Source of Bleeding can be from disruption of any vessel in the retina as well as extension through the retina from other areas.
2. When bleeding stops, the blood is typically cleared from the retina at an approximate rate of 1% per day.

Question 6

Investigations of Vitreous Haemorrhage (5).

Answer 6

1. Dilated Fundoscopy - Haemorrhage in Vitreous Cavity.
2. Slit-Lamp : RBCs in Anterior Vitreous Humour.
3. US - Exclude Retinal Detachment/Tears.
4. Fluorescein Angiography - Neovascularisation.
5. Orbital CT - Open Globe Injury.