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Vitreous haemorrhage (Aetiology (Degenerative
Ageing, Vascular
Retinal…
Vitreous haemorrhage
Aetiology
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Vascular
Retinal neovascularisation (BRVO, CRVO, DM)
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Diagnosis
Examination
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Fundoscopy
Absent red reflex
Blood in vitreous, unable to see retina
Investigations
Bloods
FBC, U+E, LFTs, clotting,
glucose (DM), lipids
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History
FH
CVD, DM, ocular disease
SH
Occupation, driving, smoking, alcohol
DH
Current meds, allergies
PMH
CVD, DM, trauma to eye
PC/HPC
Sudden, painless loss of vision
Black/red floaters in vision
Pathophysiology
Neovascularisation
Retinal ischemia causes new vessel formation
Vessels often irregular and poorly formed, prone to bleeds
Bleeding from vessels into the vitreous
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Management
Surgical
Laser
Indication: ASAP
MOA: ablate causative vessels,
prevent further bleeding and damage
Vitrectomy
Indication: persistent haemorrhage
MOA: removal of bloody vitreous with
replacement with clear vitrous
Conservative
Information, advice, support
Referral to ophthalmology ASAP
Watch a wait (self resolves)
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Definition
Leakage of blood from retinal
vessels into the vitreous
of the eye, reducing vision
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