Blood in the vitreous

Introduction Blood stains in the vitreous are a common complication of visual impairment caused by ocular trauma or retinal vascular disease. On the one hand, bleeding not only makes the refractive medium turbid, but also hinders the light from reaching the retina, and it can cause serious damage to the eye tissue; On the other hand, the body's response to bleeding can gradually clear the blood. In different cases, the consequences of vitreous hemorrhage are very different, according to the primary injury, the amount of bleeding in the off-duty, the absorption of bleeding and the performance of the eye reaction, etc., timely appropriate clinical treatment.

Cause

Any cause of retinal vascular or neovascular tissue hyperplasia, neovascularization, ocular trauma and fundus vascular disease may occur in the vitreous cavity, which is the most common cause of clinical vitreous hemorrhage.

In ocular trauma, perforation of the eyeball or blunt contusion of the eye can cause traumatic vitreous hemorrhage, perforation of the cornea, scleral perforation and residual foreign body injury in the posterior segment of the eye. The incidence of vitreous hemorrhage is high, resulting in blunt contusion of the eyeball. The instantaneous deformation of the eyeball can cause rupture of the choroid of the retina and hemorrhage; the anterior vitreous hemorrhage can be caused by damage to the ciliary body.

an examination

Related inspection

Eye and sacral area CT examination ophthalmoscopy

Ultrasound examination has a great diagnostic value for vitreous hemorrhage, especially when it is not directly visible. A small amount of diffuse bleeding may result in a negative result with B-mode ultrasound. This is because there is not enough echo interface in the vitreous, and type A Ultrasound scans may show low baseline echoes. When vitreous hemorrhage is dense, both low- and medium-amplitude scattered echoes can be seen in either type A or B-mode ultrasound, and when scanned with high sensitivity, bleeding Density and distribution are shown more clearly; scanning with reduced sensitivity can reduce echo amplitude, and most echo points are removed, so it can be determined whether retinal detachment is present at the same time. Therefore, ultrasound can determine the posterior segment of the eye and vitreous hemorrhage. Degree, whether there are lesions such as retinal detachment, to determine the prognosis of vision, if necessary, can be repeated.

Differential diagnosis

Differential diagnosis of blood stains in the vitreous:

Posterior vitreous detachment caused by vitreous hemorrhage should be differentiated from retinal detachment in the diagnosis of ultrasound images. The retinal detachment often has high-amplitude echoes. When the sensitivity is changed, the retinal echo changes little, and the detached retina can often be traced to the attachment. At the site or optic disc, the traction retinal detachment will show a pulling shape, and after the simple vitreous detachment, the posterior vitreous interface has obvious posterior motion when the eyeball rotates, and the echo amplitude is weakened when the sensitivity of the machine is lowered.

Retinal hemorrhage: Retinal hemorrhage is a common complication of visual hazard caused by ocular trauma or retinal vascular disease. On the one hand, bleeding not only makes the refractive medium turbid, hinders light from reaching the retina, but also can cause serious damage to the eye tissue; On the other hand, the body's response to bleeding can gradually clear the blood. In different cases, the consequences of vitreous hemorrhage are very different, according to the primary injury, the amount of bleeding in the off-duty, the absorption of bleeding and the performance of the eye reaction, etc., timely appropriate clinical treatment.

Uveitis: Uveitis refers to inflammation of the iris, ciliary body, and choroid; the blood supply to the iris and ciliary body is the same as the iris, so the two are often inflamed at the same time, and are collectively called iridocyclitis. If the choroid is also inflamed at the same time, it is called uveitis. Uveitis is an eye disease that occurs mostly in young adults. It has a wide variety of causes and complex causes. Improper treatment can lead to blindness. It plays an important role in blinding eye diseases and has attracted worldwide attention. Because the mechanism of its onset and recurrence is not completely clear, its prevention is impossible, and the treatment effect is also not ideal. Therefore, the search for reasonable and effective treatment drugs has become an urgent problem in the field of ophthalmology.

Subconjunctival hemorrhage: sub-conjunctival hemorrhage is bright red, flat, clear boundary or flaky. When the amount of bleeding is large, it is black and red. Except for bleeding caused by acute conjunctivitis, there are no signs of inflammation. When the blood is absorbed, it changes from red to orange or yellow and gradually disappears without leaving traces. Moderate bleeding is usually fully absorbed within 1 to 2 weeks.

Conjunctival hemorrhage: caused by small blood vessel rupture. Most common after trauma and surgery. A small amount of bleeding is seen in acute conjunctivitis. Since the blood is emitted, it is more common in the elderly. Such as physical exertion, severe cough and dry stool; blood diseases, arteriosclerosis, hypertension, diabetes and a variety of high fever infectious diseases can also be caused. Eye bleeding: Eye bleeding is a common disease. Ocular hemorrhage can be local lesions of the eye, can also be the manifestation of systemic diseases in the eye, ocular bleeding (including extraocular or internal bleeding), the cause is caused by trauma or pathological, while pathological tends to Systemic disease factors are related. Ocular bleeding includes eyelid hemorrhage, conjunctival hemorrhage, corneal (internal) hemorrhage, eyelid hemorrhage, optic nerve hemorrhage, anterior chamber hemorrhage, vitreous hemorrhage, iris hemorrhage, ciliary body hemorrhage, choroidal hemorrhage, retinal hemorrhage, etc. Due to different bleeding sites and properties, different symptoms such as visual impairment, diplopia, pain, and shame may occur.

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