Vitreous Hemorrhage

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A vitreous hemorrhage occurs when blood leaks into the vitreous, the clear, gel-like substance that fills the center of the eye. Because the vitreous is normally transparent, even a small amount of blood can significantly interfere with vision. Vision may become blurry, cloudy, or suddenly very dark.

Vitreous hemorrhage is a sign of an underlying eye condition rather than a disease itself, and prompt evaluation by a retina specialist is important to determine the cause.

 

What Causes Vitreous Hemorrhage?

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Vitreous hemorrhage most commonly results from abnormal or damaged blood vessels in the retina. Common causes include:

• Diabetic retinopathy (the most common cause in adults)

• Retinal tears or retinal detachment

• Posterior vitreous detachment (PVD) with traction on retinal blood vessels

• Retinal vein occlusion

• Eye trauma or injury

• Prior eye surgery

• Less commonly, retinal tumors or inflammation

 

In many cases, bleeding occurs suddenly.

 

Symptoms

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Symptoms can vary depending on the amount of bleeding and may include:

• Sudden appearance of many floaters or dark spots

• Cobweb-like shadows or haze

• Blurred or reduced vision

• A red or dark tint to vision

• Severe cases may cause near-complete vision loss in the affected eye

 

Vitreous hemorrhage is typically painless.

 

How Vitreous Hemorrhage Is Diagnosed

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Diagnosis begins with a dilated eye examination. If blood obscures the view of the retina, additional testing may be needed, such as:

• Ultrasound imaging to evaluate the retina for tears or detachment

• Optical Coherence Tomography (OCT) once the blood begins to clear

• Retinal photography or angiography in select cases

 

Identifying the underlying cause is critical to proper treatment.

 

Treatment Options

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Treatment depends on the cause, severity, and duration of the hemorrhage.

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Observation

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• Small hemorrhages may clear on their own over weeks to months

• Patients are monitored closely to ensure no retinal tears or detachment are present

Medical or Laser Treatment

• Laser therapy may be used to treat abnormal retinal blood vessels

• Anti-VEGF injections may be used in conditions such as diabetic retinopathy or retinal vein occlusion

 

Surgical Treatment

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• A vitrectomy may be recommended if:

  • The hemorrhage does not clear

  • Vision remains significantly impaired

  • A retinal tear or detachment is present

• During surgery, the vitreous and blood are removed and the underlying problem is addressed

 

Prognosis

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Visual recovery depends on:

• The underlying cause

• How quickly treatment is initiated

• The health of the retina and macula

 

Many patients experience significant improvement once the blood clears or after appropriate treatment.

 

Living With Vitreous Hemorrhage

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Patients may be advised to:

• Avoid strenuous activity temporarily

• Sleep with the head elevated to help blood settle

• Monitor for worsening symptoms

 

Sudden changes in vision should always be reported promptly.

 

When to Seek Immediate Care

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Seek urgent evaluation if you experience:

• Sudden vision loss

• A rapid increase in floaters

• Flashes of light

• A curtain or shadow in your vision

 

These symptoms may indicate a retinal tear or detachment requiring immediate treatment.