Vitreous haemorrhage is bleeding into the vitreous, the transparent gel that fills the back of the eye. Because light has to pass through this gel to reach the retina, even a small bleed casts floaters, haze or shadows across your vision. It is almost always a symptom of something else — commonly diabetic eye disease or a retinal tear — so the priority is an urgent examination to find and treat the cause. Many bleeds clear on their own; persistent ones are cleared with a vitrectomy (from £6,100).
What is vitreous haemorrhage?
The vitreous is normally crystal clear. When a blood vessel in or near the retina bleeds, blood disperses into this gel and blocks light from reaching the retina, reducing vision in proportion to the amount of bleeding. A few drops cause floaters; a large bleed can black out vision in that eye almost completely.
A vitreous haemorrhage is not a diagnosis in itself but a sign of an underlying problem. The two questions that matter are where is the blood coming from and is there a retinal tear or detachment behind it — which is why every vitreous haemorrhage needs a specialist examination.
Symptoms
Symptoms come on suddenly and painlessly, and depend on how much bleeding there is:
- A sudden shower of floaters — specks, dots or cobweb-like strands
- A red or smoky haze over your vision
- Shadows or streaks drifting across your sight
- Sudden, marked loss of vision in that eye with a large bleed
- Vision that is worse in the morning, as settled blood disperses again on rising
Because these can also signal a retinal tear or detachment, a sudden onset should be assessed urgently.
Sudden floaters or a haze over your vision? This needs prompt assessment to rule out a retinal tear and treat the cause of the bleed.
Request an urgent assessmentCauses & risk factors
Vitreous haemorrhage results from bleeding from abnormal or damaged retinal vessels. The main causes are:
- Diabetic retinopathy — the most common cause, where fragile new vessels bleed into the gel
- Retinal tear or detachment — a tear can rupture a blood vessel as it forms
- Posterior vitreous detachment — the gel pulling away can tear a small vessel
- Retinal vein occlusion or other vascular disease
- Eye injury or trauma
- Blood-thinning medication, which can make bleeding more likely
How it is diagnosed
The aim is to identify the source of the bleed and check the retina is intact:
- Dilated retinal examination — the consultant examines the retina; if the bleed is light enough, the cause can be seen directly.
- Ocular ultrasound (B-scan) — essential when blood obscures the view, to check for a retinal tear or detachment behind the haemorrhage.
- Optical coherence tomography (OCT) — images the macula once the view allows.
- Assessment of the other eye and general health — to identify diabetes or vascular disease as the cause.
Treatment options
Treatment targets both the blood and its cause — see our vitreous haemorrhage treatment overview.
- Observation — many haemorrhages clear gradually on their own over weeks as the blood is reabsorbed, with regular monitoring to ensure the retina is safe.
- Treating the cause — laser or anti-VEGF injections for diabetic retinopathy, or sealing a retinal tear with laser, to stop further bleeding.
- Vitrectomy — if the blood does not clear or a retinal detachment is present, the vitreous gel and blood are removed surgically and the underlying problem repaired. See vitreoretinal surgery pricing.