The vitreous is the gelatinous-like substance that makes up approximately two-thirds of the eye’s volume. The vitreous is located in between the lens, in the front of the eye, and the retina, in the back of the eye. In a healthy vitreous, there are no blood vessels, however some diseases, such as diabetic retinopathy, can lead to the development of new blood vessels which grow into the vitreous gel. These blood vessels are often fragile and susceptible to leaking blood and fluids.
A vitreous hemorrhage occurs when a blood vessels ruptures and causes bleeding within the vitreous gel. There are various causes of a vitreous hemorrhage, including:
- Diabetic retinopathy
- Sickle cell retinopathy
- Retinal vein occlusion
- Retinopathy of prematurity
- Ocular ischemic syndrome
- Posterior vitreous detachment
- Retinal detachment
- Terson’s syndrome
- Retinal macroaneurysms
- Carotid artery disease
Patients with vitreous hemorrhage usually notice the following symptoms:
- A sudden, significant increase in the number and size of floaters blocking the vision
- Vision loss
- Blurry, cloudy or hazy vision
- Flashes of light
Diagnostic and treatment
If you note the above-mentioned symptoms, you should go to the ophthalmologist right away and undergo an examination in order to check there is no other complication, such as retinal detachment or glaucoma.
In some cases, the effects of vitreous hemorrhages resolve spontaneously in 2-3 months, although if the bleeding is not reabsorbed, it may require a surgery called vitrectomy.
Vitrectomy is eye surgery to remove the vitreous, which is performed both for the treatment of vitreous haemorrage and in order to provide the vitreoretinal surgeon with access to the retina.
During the procedure, the surgeon makes several small incisions in the sclera, then delicately cuts and removes the vitreous body using a 3-port approach with 25-gauge or 27-gauge instrumentation. Currently, vitrectomy is a routine surgery and can usually be performed safely as an outpatient procedure with excellent results.