- management of vitreous haemorrhage (1)
- sudden loss of vision is an ophthalmological emergency
- it requires immediate referral to the eye emergency department
- retinal detachment should be first excluded as the cause
- ultrasonography may be necessary to detect a retinal detachment, especially if the posterior segment is not visible
- if the posterior pole is is not visible(1)
- bed rest is recomended
- head of the bed should be kept elevated when sleeping
- this lets the haemorrhage to resolve to the lower pole
- superior part of the retina may then be visible
- once the retina is visualized, the underlying aetiology should be treated early
- if the retina is attached
- may be observed as an outpatient (1)
- can engage in normal day to day living
- follow up
- clearing of the vitreous hemorrhage should be monitored
- this should be done periodically
- in case of recurrent vitreous hemorrhage
- referral to a retinal specialist is needed
- may need vitrectomy
Retinal detachment is an indication for urgent vitrectomy
- other indications for vitrectomy include
- when the vitreous hemorrhage is not clearing
- neovascularization of the iris
- ghost cell glaucoma
Notes:
- retinal breaks are treated with
- cryotherapy
- laser photocoagulation
- aspirin and other forms of anticoagulation ( warfarin, clopidogrel) (1)
- does not worsen the condition
- can be continued after a vitreous hemorrhage
Reference:
(1) vitreous hemorrhage: diagnosis and treatment, John P. Berdahl, et al, copyright © american academy of ophthalmology, 2007