Formula Medical Group
Apple Valley, CA
760-242-1234


James Krider, MD


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Eye hemorrhages

What are eye hemorrhages?

An eye hemorrhage is a discharge of blood within the eye. It often occurs inside the conjunctiva, the membrane that covers the front of the eyeball. This type of bleeding is called a subconjunctival hemorrhage and produces an easily visible red patch on the eye.

Less commonly bleeding may also take place in the vitreous body, the large, round chamber located between the lens, near the front of the eye, and the retina at the back of the eye. This space contains the vitreous humor, a clear, gelatinous fluid.

The most serious eye hemorrhages take place in the retina itself. If the eye is thought of as a camera, the retina could be considered the film. It contains the rod cells that perceive light and the cone cells that perceive both light and color.

What causes eye hemorrhages?

A subconjunctival hemorrhage may be brought on by a minor

SYMPTOMS

  • Red patches on the surface of the eyeball.
  • 'Floaters,' or moving spots before the eyes.
  • Diminishing vision.

blow or trauma, or even by straining, sneezing, or coughing. In some cases, recurrent hemorrhages of this type may signify the onset of a blood disorder or be caused by taking aspirin or other drugs that reduce blood clotting.

Vitreous or retinal hemorrhages may be the result of a complication of diabetes known as diabetic retinopathy. They may also be caused by high blood pressure or by an injury to the retina.

How are eye hemorrhages diagnosed and treated?

A subconjunctival hemorrhage can usually be diagnosed visually, but vitreous and retinal hemorrhages require an ophthalmological examination with specialized instruments. Most subconjunctival hemorrhages require no treatment. Vitreous hemorrhages often slowly reabsorb without treatment, but they must be watched because they may form bands that obscure vision and can result in a detached retina, a serious problem requiring immediate attention to prevent loss of vision. If the vitreous humor has become clouded by blood, an operation called a vitrectomy may be necessary to replace the natural fluid with a clear, saline solution.

Bleeding under the conjunctival membrane may look alarming, but is seldom serious.

Bleeding under the conjunctival membrane may look alarming, but is seldom serious.

Retinal bleeding due to diabetes is more serious, and is a major cause of blindness. If the hemorrhage is localized, it can sometimes be controlled with laser surgery, a procedure that uses powerful light beams to seal off the hemorrhaging vessels. This procedure does not usually require hospitalization.

Hemorrhages caused by high blood pressure can usually be prevented by lowering the blood pressure.

What can I do myself?
Overuse of aspirin or other drugs that promote bleeding should be avoided, especially if the person has high blood pressure. Anyone with diabetes or high blood pressure should follow a doctor's recommendations for keeping the disease under control. In addition, the person should have regular eye examinations. Otherwise, self-treatment of eye hemorrhages is not effective.

When should I see my doctor?
Regular eye examinations are necessary to detect vitreous or retinal hemorrhages and are particularly important for anyone who has high blood pressure or diabetes.

What will the doctor do?

To detect bleeding in the retina, the doctor will examine the eye by using a lighted instrument called an ophthalmoscope. This examination will reveal any damage to the blood vessels inside the eyes and will also show whether the retina has become detached from the back of the eyeball. Eye drops may also be used during the examination to enlarge the pupil.

If hemorrhages are detected within the eye, treatment

Bleeding in the retina or eye chamber can cause loss of vision.
Bleeding in the retina or eye chamber can cause loss of vision.

will depend upon their location and severity. Increasingly, laser surgery is being used to prevent the retinal hemorrhages that are common in diabetes.

The course of eye hemorrhages

A subconjunctival hemorrhage usually disappears on its own within a week or so. The hemorrhage does not pose a threat to sight.

Diabetic retinopathy begins with a widening of blood vessels inside the retina, leading to tiny out­growths that break and cause small hemorrhages. These may vanish initially, leaving minute, white scars. These scars eventually cause diminished vision, but are initially too small to be noticeable. As the retinopathy progresses, however, new blood vessels grow, swell, and bleed, and eventually the hemorrhages and scarring obscure sight. The swelling and bleeding may also cause the retina to become detached, which can lead to a permanent loss of vision if it is not reattached promptly.

In high blood pressure, eye hemorrhages may lead to spots before the eyes, but in the early stages, there is no significant loss of vision. The hemorrhages are important, however, since they are an indication of similar damage in the kidneys, another of the "target organs" for damage from high blood pressure.

Are eye hemorrhages dangerous?
Subconjunctival hemorrhages generally are not serious, but hemorrhages in the vitreous humor or retina can lead to diminished vision or even blindness. They may also indicate serious problems in other organs.

What can I do to avoid eye hemorrhages?

  • Protect eyes when working or playing sports. Wear safely glasses whenever required to take precautions to avoid a blow to the eyes.
  • A person who has diabetes should make every effort to keep the disease under control through diet, exercise, and medication (if needed).
  • Have blood pressure checked regularly, since this silent problem usually does not reveal itself through any symptoms.
This article was last reviewed November 27, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Diabetes
High blood pressure
Med's, anti-inflammatory
Trauma


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