Vitreous Detachment

The vitreous is the gelatinous-like substance that makes up approximately two-thirds of the eye’s volume. The vitreous is located in between the lens, in the front of the eye, and the retina, in the back of the eye. In a normal, healthy vitreous, there are no blood vessels, yet diseases, such as diabetic retinopathy, can lead to the development of new blood vessels which grow into the vitreous gel. These blood vessels are often fragile and susceptible to leaking blood and fluids.

Causes Of A Vitreous Hemorrhage

A vitreous hemorrhage occurs when a blood vessels ruptures and causes bleeding within the vitreous gel, causing visual symptoms. There are various causes of a vitreous hemorrhage, including:

  • Diabetic retinopathy
  • Sickle cell retinopathy
  • Retinal vein occlusion
  • Retinopathy of prematurity
  • Ocular ischemic syndrome
  • Posterior vitreous detachment
  • Retinal detachment
  • Terson’s syndrome
  • Retinal macroaneurysms
  • Tumor
  • Leukemia
  • Nearsightedness
  • Carotid artery disease
  • Trauma
  • Choroidal neovascularization

Symptoms Of A Vitreous Hemorrhage

Patients with vitreous hemorrhage usually notice the following symptoms:

  • A sudden, significant increase in the number and size of floaters blocking their vision
  • Vision loss
  • Blurry, cloudy or hazy vision
  • Flashes of light

When symptoms occur, it is important for patients to seek prompt medical attention.

Diagnosis Of A Vitreous Hemorrhage

The doctor will examine the patient’s eyes as well as review their medical history to determine the cause of the hemorrhage. An appropriate treatment will be recommended. To confirm the diagnosis, a series of diagnostic tests may be performed such as:

  • Gonioscopy
  • IOP
  • B-scan
  • Dilated eye examination
  • Indirect ophthalmoscopy
  • Slit-lamp examination

Treatment Of A Vitreous Hemorrhage

If a retinal detachment or break is diagnosed, a vitrectomy is performed immediately. Treatment for a vitreous hemorrhage will be determined based on the underlying cause of the condition. Some of the treatments for a vitreous hemorrhage include:

  • Vitrectomy
  • Cryotherapy
  • Laser photocoagulation
  • Intravitreal injections
  • Observation
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