Retina

Vitreous Hemorrhage

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Vitreous Hemorrhage

  • Risk Factors
  1. Diabetes Mellitus (Diabetic Retinopathy)
  2. Coagulopathy
  3. Retinal Tear (from Vitreous Detachment)
  4. Proliferative sickle Retinopathy (Sickle Cell Anemia)
  5. Eye Trauma
  6. Macular Degeneration
  7. Retinal artery micro-aneurysm
  8. Terson Syndrome (associated with Subarachnoid Hemorrhage)
    1. Occurs in 20-30% of SAH cases, and is associated with a worse prognosis
  9. Coagulopathy
    1. Thrombocytopenia
    2. Idiopathic Thrombocytopenic Purpura
    3. Hemophilia
    4. Leukemia
  • Symptoms
  1. Acute Vision Loss lasting for minutes to hours
    1. Visual Floaters or "cobwebs"
  • Signs
  1. Funduscopy
    1. Red Haze of Fundoscopy obscures the Retina
  2. Pupil reflex
    1. Normal (consider Retinal Detachment if abnormal pupil reflex)
  • Management
  1. Urgent ophthalmology evaluation within 24 hours
  2. Bedrest
  3. Elevate head of bed to 30 degrees
  4. Hold Anticoagulants if possible (including Aspirin and NSAIDs)
  • Management
  1. Hartmann (2016) Crit Dec Emerg Med 30(6): 3-11