Vitreous Hemorrhage

Vitreous hemorrhage is perceived as a sudden but not always complete loss of vision. One of the most common causes of hemorrhage is the detachment of the vitreous. Other reasons are chronic vascular diseases of the retina such as diabetes, vascular occlusions etc., or degenerative diseases, such as age-related macular degeneration.

In the case of a vitreous hemorrhage, the patient must undergo a fundoscopy immediately to determine the cause of the hemorrhage. If that is not possible, the use of ophthalmic ultrasound is necessitated to aid the diagnosis and to rule out a retinal detachment. However, the ultrasound cannot exclude the presence of a retinal tear beyond any doubt.
If the cause of the hemorrhage is not obvious (e.g. known diabetic retinopathy) then it will be perceived to have been caused by a detachment of the vitreous until proven otherwise. In this case, the risk of a tear is over 50%. If the examination of the retina and the treatment of tears are not possible, then a decision to undergo surgery should be discussed as a means of exploration of the hemorrhage cause. Vitreous hemorrhage in the presence of a retinal detachment increases the risk of reattachment failure.