Intraocular hemorrhage
An intraocular haemorrhage or vitreous haemorrhage is bleeding in the internal part of the eye known as the vitreous cavity. Vitreous humour is a clear gel that makes up two-thirds of the eye's total volume, consists 99 % of water and lies between the retina at the back and the crystalline lens and the ciliary body at the front.
When there's a haemorrhage in the vitreous humour, this loses its transparency and light can't pass through it, causing the loss of vision.
Causes
Here are some causes of intraocular hemorrhage:
- Trauma
- Proliferative diabetic retinopathy
- Retinal venous occlusion
- Vasculitis, such as Eales disease
- Hypertensive retinopathy
- Ocular ischemic syndrome
- Blood dyscrasias
- Bleeding and coagulation disorders
- Shaken baby syndrome
- Purtscher retinopathy
- Terson syndrome
- Anemia
- Leukemia
- Sea-fan neovascularization
- Normal-tension glaucoma
- Primary open-angle glaucoma
- Posterior vitreous detachment
- Optic neuropathy
Symptoms
Some signs and symptoms of intraocular hemorrhage include:
- Sudden, painless complete vision loss
- Mild haze
- New floaters
- Shadows
- "Cobwebs"
- Red tint to vision
- Flashes of light in peripheral vision (photopsias)
- Blurred vision
- Small translucent spots or shadows
- Loss of vision of spots that are suspended in vision (floaters)
- Visual acuity can be quite variable among patients
- Photopsias from traction applied to the retina
- Density and location of the hemorrhage governs the severity of symptoms
- Depending on the underlying mechanism, patients may also describe flashes of light in their peripheral vision (i.e., photopsias) from traction applied to the retina
Diagnosis
Here are some ways to diagnose intraocular hemorrhage:
- Comprehensive eye examination
- Visual acuity test
- Eye fundus examination
- Eye ultrasound
- Scleral depression
- Ultrasound (B-scan)
- Rule out retinal tear or detachment
- Monitor intraocular pressure
- Uncovering the underlying etiology
