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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • 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


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