12/11/2025
What is Vitreous Hemorrhage (VH) ?
⭐ Definition:
Vitreous hemorrhage refers to bleeding into the vitreous humor, the clear, gel-like substance that fills the space between the lens and the retina in the posterior part of the eye.
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⭐ Causes:
👉1. Diabetic Retinopathy – most common cause due to fragile neovascular vessels.
👉2. Retinal Vein Occlusion – especially branch or central retinal vein occlusion.
👉3. Retinal Tear or Detachment – bleeding occurs when retinal vessels are torn.
👉4. Trauma – blunt or penetrating injury to the eye.
👉5. Posterior Vitreous Detachment (PVD) – traction on retinal vessels may cause bleeding.
👉6. Age-related Macular Degeneration (AMD) – due to choroidal neovascular membrane rupture.
👉7. Tumors or Blood Disorders – less common causes (e.g., leukemia, anemia).
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⭐Symptoms:
👉Sudden painless loss or blurring of vision.
👉Floaters (black spots, cobwebs, or red haze) in vision.
👉Reduced visual acuity (depending on the amount of blood).
👉Sometimes photopsia (flashes of light).
👉In dense hemorrhage – complete vision loss, appearing like a curtain or shadow.
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⭐Signs (on Examination):
Fundus view obscured (can’t see retina clearly).
On B-scan ultrasonography – echoes within vitreous cavity indicating hemorrhage.
May find associated retinal tear, detachment, or neovascularization.
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⭐Diagnosis:
Clinical examination (slit-lamp with +90D or indirect ophthalmoscopy).
B-scan ultrasonography if fundus not visible.
OCT or fluorescein angiography after blood clears (to assess underlying cause).
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⭐Treatment:✅
👍1. Initial Management:
Bed rest with head elevated (to allow blood to settle inferiorly).
Avoid strenuous activity and aspirin/anticoagulants (if possible).
👍2. Medical Treatment:
Treat underlying cause (e.g., control diabetes, manage vein occlusion).
Anti-VEGF injections if neovascularization present.
👍3. Surgical Treatment:
Pars plana vitrectomy – indicated if:
Non-clearing VH (>3 months).
Recurrent bleeding.
Associated retinal detachment or tear.
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⭐Prognosis:
Depends on the cause and extent of bleeding.
Mild cases may clear spontaneously.
Recurrent or severe cases may lead to vision-threatening complications if not treated promptly.