Vitreous hemorrhage is the leakage of blood into and also around areas that surrounds the vitreous humor of the eye. The vitreous humor is a gel like substance that occupies the space between the lens and the retina of the eye. The eye is filled with a clear gel, when blood leaks into this gel due to damage or tear to the retina, it is known as vitreous hemorrhage. A number of conditions can cause blood leakage into the vitreous humor and can result in blurred vision, as the fluids that leaked into the eyes block lights that passes into the eye.
Vitreous hemorrhage is one of the most common diagnosis for painless reduction in vision, mostly caused by retinal vascular disorders, which is common to ailments such as diabetes, hematological abnormalities and hypertension. At other times it may be the early stages of retinal test and detachment that can damage the vision of not diagnosed and treated early.
Vitreous hemorrhage is a usual cause of acute vision loss, with 7 people in 100000 reported to have it, therefore it is frequently engaged by ophthalmologists. The diagnosis of vitreous hemorrhage is mostly easy to determine, but further test is needed to know the underlying cause.
Symptoms of vitreous hemorrhage
The usual symptoms of vitreous hemorrhage includes:
- Blackspots, floaters which are faint and look like cobwebs floating through the field of vision, and photopsia, which are flashes of light that passes briefly in the peripheral vision.
- Loss of vision.
- Seeing red hues.
- Scotomas- change or distortion of the visual field (blind spot)
- Blurry vision.
- Reddish tint to vision.
- Spots in the field of vision that looks like transparent floating materials.
- Spots that move when your eyes move and when you try to look at them they move quickly out of the field of vision.
Diagnosis for vitreous hemorrhage
Vitreous hemorrhage is diagnosed by knowing the signs and symptoms, doing some eye examinations, and performing tests to know the root causes. Some of the tests to determine vitreous hemorrhage include, pupil examination, pupil dilation, examining the eye with a microscope, ultrasound examination, but it does not have a clear view of the back of the eye, a CT scan to check for eye injury, checking for specific causes like diabetes by doing blood tests, or by visiting a retinal specialist.
When you go for check up you will be asked about your medical history and the symptoms, a physical examination will be performed on you, the doctors may suspect a hemorrhage based on the risk factors and the symptoms you told them. Vitreous hemorrhage is also detected with a tool called the slit lamp. This lamp allows the eye specialist to search for leakage or damage to blood vessels in the back of the eye.
Causes of vitreous hemorrhage
There are varieties of causes that leads to vitreous hemorrhage, medical factors and also injuries that can cause damage to the eyes that leads to vitreous hemorrhage include,
- Retinal tear or detachment: A test to the retina will allow fluids or blood from the eye to extravasate behind the retina, which results to retinal detachment. When this happens the the blood that is housed in the retinal blood vessel flows into the vitreous humor. Retinal tear or detachment accounts for more than 44% of the vitreous hemorrhage cases reported.
- Trauma: Some injuries will result to the blood vessels located in the back of the eye to bleed, leading to vitreous hemorrhage. A sudden hard impact to the eye area can make the blood vessels in the retina to burst or tear, spilling blood to the back of the retina. Trauma is the leading cause of vitreous hemorrhage in young people, accounting for almost 20% of cases reported.
- Diabetic retinopathy: The most prevalent cause of vitreous hemorrhage especially in the United States is diabetic retinopathy. Unusual blood vessels form in the back of the eye of someone who has diabetes. These blood vessels are weak and can break anytime, causing hemorrhage in the vitreous humor. Diabetic retinopathy accounts for almost 54% of vitreous hemorrhage reported in the United States.
- Posterior vitreous detachment: As an individual ages a bag of fluid may form in the vitreous humor. When these bags of fluid develop near the back of the eye. When this happen there is a possibility of the vitreous pulling away from the retina and tearing it. This will evidently lead to a case of vitreous hemorrhage. Posterior vitreous detachment accounts for over 11% of vitreous hemorrhage cases.
- Inflammation that occurs in the back of the eye: Inflammation that occurs on the layers of the uvea in the back of the eye also called posterior uveitis. Posterior uveitis is which is responsible for eye floaters are triggered by either infection or inflammatory diseases.
- Growth of abnormal blood vessels: Various eye conditions can trigger the growth of some abnormal blood vessels that extravasates into the vitreous gel of the eye. The causes of abnormal blood vessels to grow into the eyes include the end stages of diabetic retinopathy, wet AMD and also retinal vein occlusion.
- Bleeding from other parts of the eye: Occasionally bleeding from other parts of the eye which isn’t the retina can lead to vitreous hemorrhage. Although this is rare but there have been reported cases of this cause. A hemorrhage in another part of the eye, or even a tumor may allow blood to flow or leak into the vitreous humor.
There are other causes of vitreous hemorrhage, although they are less common but they make up to 18% of cases, they include, Terson syndrome, proliferative sickle cell retinopathy, age related macular degeneration, and macroaneurysm. Studies show that about 7 cases in 100000 have no known cause.