Vitreous haemorrhage and posterior vitreous detachment Flashcards
define vitreous haemorrhage
bleeding into the vitreous humour
one of the most common causes of sudden painless vision loss
source of bleeding in vitreous haemorrhage
can be disruption of any vessel in the retina as well as the extension through the retina from other areas.
causes of vitreous haemorrhage 3
proliferative diabetic retinopathy
posterior vitreous detachment
ocular trauma- most common cause in children and young adults
symptoms of vitreous haemorrhage 3
usually acute or subacute
painless vision loss or haze (commonest)
red hue in vision
floaters or shadows/dark spots in the vision
sx of vitreous haemorrhage2
decreased visual acuity
-variable depending on degree of vitreous haemorrhage
visual field defect if severe haemorrhage
investigations for vitreous haemorrhage 5
dilated fundoscopy
-may show haemorrhage in vitreous cavity
slit-limp exam
-RBC in anterior vitreous
US
-useful to rule out retinal tear/detachment and if haemorrhage obscures the retina
fluorescein angiography
-identify neovascularization
orbital CT
-used if open globe injury
Mx of vitreous haemorrhage 2
mild- no treatment required and eye will naturally heal itself
severe cases- vitrectomy surgery
define posterior vitreous detachment
with age, vitreous body becomes less firm and less able to maintain its shape
posterior vitreous detachment occurs when the vitreous gel comes away from the retina
v common in older patients
what is the vitreous body made of 2
water
collagen
presentaiton of posterior vitreous detachment 4
can be asymptomatic
painless
spots of vision loss
floaters
flashes
Mx of posterior vitreous detachment
no treatemtn necessary
-over time syx will improve as brain adjusts
what can posterior vitreous detachment predispose patients too
developing retinal tears and detachments
-can also present v similarly
ESSENTIAL to exclude and assess risk of retinal tear or detachment with thorough assessment of retina
