The majority of the eyeball is filled with an egg white-like fluid called vitreous. Bleeding that occurs into this fluid is called intraocular bleeding (vitreous hemorrhage). Although there are many causes of intraocular bleeding, most of them are vascular causes. Intraocular bleeding is common, especially in the advanced stages of diabetic retinopathy that develops due to diabetes. Apart from this, it may also develop following occlusion in the retinal vessels. It may occur with the presence of a retinal tear as a result of the lack of development of retinal vessels due to premature birth, or with systemic diseases such as leukemia due to indirect or direct trauma.
Intraocular bleeding
The most common causes of intraocular bleeding are listed below:
- Diabetic retinopathy (32-54%)
- With retinal tear (12%) -44)
- Posterior vitreous detachment (4-12%)
- Retinal detachment (7-10%)
- Sickle cell anemia (1-6%)
- Retinal macroaneurysm (1-7%)
- Wet-type macular degeneration (1-5%)
- With intracranial hemorrhage (1%)
- Trauma (12-19%)
- Retinal vein occlusion (4-16%)
Intraocular hemorrhage, regardless of the cause, can cause eye problems for a long time. If it remains inside, it may cause complications beyond the damage caused by the underlying disease. One of these is that the iron element in the blood cells is released and absorbed by the cells in the retina and other layers, resulting in some toxic effects. These toxic effects prevent the healthy functioning of retina cells. Another effect is that deformed blood cells circulating in the vitreous block the outflow pathways of the eye and increase eye pressure, that is, glaucoma.
Eye ultrasonography for intraocular bleeding
WHAT ARE THE SYMPTOMS OF INTROCULAR BLEEDING?
People with intraocular bleeding usually complain of blurred vision, floating objects, blurred vision, sensitivity to light, and shadowing. These complaints may vary depending on the intensity of bleeding. Floaters are prominent in mild bleeding, shadowing is prominent in moderate bleeding, and decreased vision is prominent in heavy bleeding.
Eye pain does not usually accompany intraocular bleeding. However, if glaucoma (increased eye pressure) occurs as a complication or there is a trauma, pain may accompany it.
Ultrasonography is a very helpful diagnostic method in intraocular bleeding. Bleeding often makes retinal examination impossible. In this case, ultrasonography gives an idea about the intensity of the bleeding, its relationship with the retina, and more importantly, whether it is accompanied by a tear in the retina or retinal detachment. If it is not planned to clean the bleeding with vitrectomy surgery in the early period, ultrasonography should be performed at frequent intervals.
Vitrectomy surgery for intraocular bleeding
WHAT IS THE TREATMENT OF INTROCULAR BLEEDING?
Treatment of bleeding varies depending on the underlying cause. If the cause is a retinal tear or retinal detachment, urgent surgery and/or laser treatment is required. If it occurs due to a systemic vascular disease such as diabetes, it should be monitored with frequent checks every 1-2 weeks by resting with the head up/upright, and if there is no opening in a period of 1-2 months, a bleeding removal surgery called vitrectomy should be performed.
Meanwhile, the patient should be consulted for systemic diseases such as diabetes, hypertension and blood diseases, and blood values in this regard should be normalized.
In cases where the visual center called the macula is healthy, post-surgical vision gain is also quite satisfactory. However, vision expectancy is relatively more limited in diseases that affect the macula, such as diabetic retinopathy and age-related macular degeneration.
Read: 0
