Intraocular bleeding - Causes and Symptoms

Definition

Blood loss in the eye is a symptom that can have different causes: it can result from the rupture of small capillaries or a larger blood vessel (in this case we speak of hemorrhage).

Depending on the site, it is possible to distinguish between subconjunctival, vitreous and retinal haemorrhages.

A subconjunctival hemorrhage appears as a simple extravasation of blood into the space located just below the conjunctiva. It can be caused by sudden increases in pressure, such as violent sneezing, trauma, stress or coughing. Capillary ruptures can also occur in people suffering from hypertension or taking anticoagulants. These haemorrhages alarm the patient, but have no pathological significance and do not cause vision problems or significant discomfort, despite the visible appearance. In most cases, treatment is not necessary and subconjunctival blood effusion is spontaneously reabsorbed within 1-3 weeks.

When bleeding affects the vitreous cavity (vitreous hemorrhages ), however, it can cause a significant reduction in vision: the blood poured into the vitreous humor, the gelatinous substance that fills the inside of the eye, prevents light from reaching the retina. If bleeding is limited, the patient may see only a couple of dark spots or loose bodies. In severe cases, the bleeding can fill the vitreous cavity and totally compromise vision (the patient could only perceive light and darkness). Blood tends to be reabsorbed within a few weeks or months, with no consequences for vision (unless the macula has been damaged). Vitreous hemorrhages can occur under conditions such as retinal detachment, neovascularization (eg due to diabetic retinopathy or age-related macular degeneration) and ocular trauma.

Retinal hemorrhages, on the other hand, are indicative of a generally systemic vascular disease (eg venous occlusion, diabetes, etc.). They manifest themselves as small or large spots of blood located in the deeper layers of the retina and are generally associated with severe changes in the eye.