Vitreous haemorrhage

  • Vitreous haemorrhage
    • usually occurs from the retinal vessels
    • may present as pre-retinal (sub-hyaloid) or an intragel haemorrhage.
    • Causes
      • Spontaneous vitreous haemorrhage from retinal breaks especially those associated with PVD.
      • Trauma to eye, which may be blunt or perforating
      • Inflammatory diseases
        • occur due to erosion of the vessels
        • Seen in  acute chorioretinitis and periphlebitis retinae primary or secondary to uveitis.
      • Vascular disorders
        • hypertensive retinopathy,
        • central retinal vein occlusion.
      • Metabolic diseases such as diabetic retinopathy.
      • Blood dyscrasias
        • retinopathy of anaemia,
        • leukaemias
        • polycythemias
        • sickle-cell retinopathy.
      • Bleeding disorders
        • purpura,haemophilia and scurvy.
      • Neoplasms.
        • retinoblastoma.
      • Idiopathic
  • Clinical features
    • Symptoms.
      • when the vitreous haemorrhage is small
        • Sudden development of floaters occurs.
      • With massive vitreous haemorrhage
        • patient develops sudden painless loss of vision.
    • Signs
      • Distant direct ophthalmoscopy reveals
        • black shadows against the red glow in small haemorrhages
        • no red glow in a large haemorrhage.
      • Direct and indirect ophthalmoscopy show presence of blood in the vitreous cavity.
      • Ultrasonography with B-scan
    • Fate of vitreous haemorrhage
      • Complete absorption within 4-8 weeks.
      • Organization of haemorrhage
      • Complications
        • vitreous liquefaction, degeneration
        • khaki cell glaucoma (in aphakia)
      • Retinitis proliferans complicated by tractional retinal detachment.
  • Treatment
    • Conservative treatment
      • consists of bed rest, elevation of patient’s head and bilateral eye patches
    • Treatment of the cause.
    • Vitrectomy by pars plana route, if the haemorrhage is not absorbed after 3 months.

Vitreous Hemorrhage
A vitreous hemorrhage is when abnormal blood vessels bleed into the vitreous, the clear gel in the middle of the eye. This bleeding can prevent light rays from reaching the retina
23 gauge sutureless vitrectomy for vitreous haemorrhage
23 gauge sutureless vitrectomy for organised vitreous haemorrhage following blunt trauma with fist 5 month back on presentation just following trauma it was a huge subhyaloid haem patient lost to follow up and reported after 5 months. Preop B-Scan showed retina well attached with membranous and dot like vit echoes
patient was a known diabetic with no diabetic retinopathy changes in other eye. Intra operatively there was no vascular pathology seen therefore endolaser was deferred
Vitrectomy for vitreous haemorrhage in vascular diseases of retina
vitrectomy is followed by endolaser in cases of vitreous haemorrhage due to vascular pathology
Vitrectomy for Vitreous Hemorrhage
Removal of a 6 month old vitreous hemorrhage using 25 gauge instruments. This 74 year old woman has had intermittent bleeding in this eye for 3 years from a branch retinal vein occlusion. Six month ago, she had severe vision loss from a vitreous hemorrhage. She had cataract surgery 3 months ago. Her intraocular pressure rose after a YAG capsulotomy to 38 mmHg which is dangerously high. The intraocular pressure rose because some of the old blood cells from the vitreous clogged the drainage channels of the eye. This is called ghost cell glaucoma. She had this surgery because of the rise in intraocular pressure and because of her longstanding poor vision from the vitreous hemorrhage. There is a sound gap in the video for about 20 seconds.
25 g. Vitrectomy for Vitreous Hemorrhage (Graphic!)
Vitrectomy surgery to remove vitreous hemorrhage or blood inside the eye. Vitrectomy is the basic operation performed by a retina specialist, in this case, I’m simply removing blood mixed in the vitreous.
vitreous haemorrhage acute on chronic
Penetrating eye injury with vitreous haemorrhage.
This young man presented with a 2wks old penetrating injury in the right eye, sutured elsewhere. You can see the traumatic iris coloboma and dense vitreous hemorrhage. the vision was only perception of light.
itreous Hemorrhage – QMH AED Ultrasound Casebook 2011/10
This video shows the transverse scan of the patient’s right eye. And you can see the anterior chamber, lens, and vitreous cavity of her right eye in this video. The important finding is the echogenic material layer inferiorly in the dependent position of the posterior chamber. Which suggested the diagnosis of vitreous hemorrhage.