Vitreous Hemorrhage
Vitreous hemorrhage is the extravasation, or leakage, of blood into the areas in and around the vitreous humor of the eye. The vitreous humor is the clear gel that fills the space between the lens and the retina of the eye. The symptoms of vitreous hemorrhage are varied but usually include painless unilateral floaters and/or visual loss. Early or mild hemorrhage may be described as floaters, cobwebs, haze, shadows or a red hue. More significant hemorrhage limits visual acuity and visual fields or can cause scotomas. Patients often say vision is worse in the morning as blood has settled to the back of the eye, covering the macula.
Vitreous Hemorrhage
Patients should be questioned regarding a history of trauma, ocular surgery, diabetes, sickle cell anemia, leukemia, carotid artery disease and high myopia.
Complete examination consists of indirect ophthalmoscopy with scleral depression, gonioscopy to evaluate neovascularization of the angle, IOP and B-scan ultrasonography if complete view of the posterior pole is obscured by blood. Dilated examination of the contralateral eye can help provide clues to the etiology of the vitreous hemorrhage, such as proliferative diabetic retinopathy.
