Symptoms bleeding eyes: Subconjunctival hemorrhage (broken blood vessel in eye) – Symptoms and causes
Subconjunctival Hemorrhage: Symptoms, Causes, Treatments
What is subconjunctival hemorrhage?
Subconjunctival hemorrhage is the term for a broken blood vessel on the surface of the eye. The clear membrane that lines the inside of the eyelid and covers the white of the eye is called the conjunctiva. It has many very small blood vessels that break easily. When a break happens, blood can leak under the conjunctiva. When this happens, the blood causes part of the white of your eye to turn bright red.
The red spots caused by subconjunctival hemorrhage can look scary. But most cases do not cause any symptoms or need treatment. It is most common in older people, but it can happen at any age.
Symptoms and Causes
What causes a subconjunctival hemorrhage?
Most cases of subconjunctival hemorrhage have no known cause. Some events and conditions can cause blood vessels on the eye to break. These include:
- Straining (during coughing, sneezing, vomiting, or while using the toilet)
- Injury to the head or eye, including infection
- Rubbing the eye too hard
- Wearing contact lenses
- Taking medications, including blood thinners and a cancer drug called interferon
What are the symptoms of subconjunctival hemorrhage?
Other than the red spot, there are no symptoms associated with subconjunctival hemorrhage. It does not cause pain or swelling, and it does not affect your vision. Most people who have so-called “red eye” do not even know it until they look in a mirror or someone tells them.
Diagnosis and Tests
How is subconjunctival hemorrhage diagnosed?
A doctor can diagnose subconjunctival hemorrhage by looking at the eye. The condition does not have any other identifying features.
Management and Treatment
How is subconjunctival hemorrhage treated?
Subconjunctival hemorrhage doesn’t require treatment. Artificial tears (eye drops) can help relieve eye irritation if it occurs. Most broken blood vessels heal within 2 weeks. Larger spots may take longer to go away. As the blood clears up, the color of the area may change, like a fading bruise.
Contact your doctor if pain accompanies the eye redness. This could be a sign of other conditions that are more serious, such as a hyphema (collection of blood in front of the colored part of the eye).
If broken blood vessels appear in your eyes often, your doctor may want you to undergo tests to try to identify an underlying cause. Sometimes, disorders related to blood clotting such as hemophilia or von Willebrand disease, make subconjunctival hemorrhage more likely.
Can subconjunctival hemorrhage be prevented?
If you have risk factors for subconjunctival hemorrhage, you can take steps to prevent broken blood vessels, including:
- Keeping your contact lenses clean
- Wearing protective eyewear during sports or activities that involve flying debris
- Checking with your doctor if you have a bleeding disorder
What Is Hyphema? – American Academy of Ophthalmology
A hyphema is when blood collects inside the front of the eye. This happens between the cornea (the clear, dome-shaped window at the front of the eye) and the iris (the colored part of the eye). The blood may cover part or all of the iris and the pupil (the round, dark circle in the middle of your eye). If you have a hyphema, your vision might be partly or totally blocked in that eye.
A hyphema usually happens when an injury causes a tear of the iris or pupil of the eye. Sometimes people mistake a broken blood vessel in the front of the eye for a hyphema. A broken blood vessel in the eye is a common, harmless condition called subconjunctival hemorrhage. A subconjunctival hemorrhage does not hurt. A hyphema, though, is usually painful. A hyphema must be treated properly or it can cause permanent vision problems.
A subconjunctival hemorrhage is when blood appears in the white of the eye from a broken blood vessel.
Hyphema symptoms include:
- bleeding in the front of the eye
- sensitivity to light
- pain in the eye
- blurry, clouded or blocked vision
Hyphema is usually caused by injuries to the eye from accidents or playing sports. Hyphema can be caused by other, less common things, including:
Always wear the right eye protection when playing sports.
Because most hyphemas happen because of sports injuries, it is important to wear protective eyewear. Sports injuries, especially with small balls like racquetballs, can cause serious eye problems. Besides hyphema, these injuries can cause cataracts, retinal detachments and glaucoma and lead to blindness. If you hurt your eye, see an ophthalmologist right away.
An ophthalmologist will examine your eye completely to diagnose a hyphema. He or she will check:
How is hyphema diagnosed?
In some cases, the ophthalmologist may order a CT scan. This scan checks the condition of the bones that form your eye sockets and other parts of your face.
How is hyphema treated?
Based on what the ophthalmologist finds when examining your hyphema, he or she may ask you to:
- wear a special shield over your eye to protect it
- cut back on physical activity, or to rest in bed
- raise the head of your bed to help your eye drain
- see your ophthalmologist often so he or she can check your healing and eye pressure. He or she may prescribe eye drops to decrease the swelling inside your eye and to ease the pain or discomfort.
Your ophthalmologist may tell you not to use aspirin because it can lead to more bleeding. In some cases, your ophthalmologist might tell you to go to the hospital so that your eye can be cared for and checked often. If the hyphema makes your eye pressure rise too high, it can lead to glaucoma or damage your cornea. If this happens, you may need surgery to remove the excess blood or eye drops for treatment.
Vitreous Haemorrhage | Causes and Treatment
What is vitreous haemorrhage?
Vitreous haemorrhage occurs when blood leaks into the vitreous humour inside the eye. The leaked blood most commonly comes from blood vessels at the back of the eye. This is more likely to happen if the blood vessels have been damaged (eg, by trauma) or are particularly fragile (because of eye disease related to diabetes).
In order for us to see clearly, the vitreous humour needs to be clear. If the vitreous humour is clouded or filled with blood, vision will be impaired. This impairment varies from a few ‘floaters’ and cloudiness of the vision through to the vision going completely dark (sometimes with a reddish tinge). Vitreous haemorrhage can therefore cause anything from floaters, hazy or dulled vision to complete loss of vision.
What is the vitreous humour?
The vitreous humour is a clear jelly-like substance that makes up about 80% of the volume of the globe of the eye. It supports the shape of the globe of the eye whilst letting light through. It is made up mainly of water but with some collagen and hyaluronic acid. The outside is made of fine fibres which are attached to the retina at the back and to the back of the lens at the front.
How common is vitreous haemorrhage?
Vitreous haemorrhage affects about 7 per 100,000 people each year. This makes it one of the most common causes of sudden deterioration in vision. It most often affects only one eye.
Who is likely to experience vitreous haemorrhage?
The most common cause of vitreous haemorrhage is severe diabetic eye disease, which is mainly seen in older adults. The other common causes of vitreous haemorrhage also tend to occur in adults aged 60 and above, except for eye trauma, which can occur at any age.
What are the causes of vitreous haemorrhage?
The most common causes, accounting for about 90% of all cases of vitreous haemorrhage, are:
- Bleeding from abnormal new blood vessels forming in advanced diabetic eye disease.
- Bleeding from tears in the retina caused by vitreous detachment (see below).
- Trauma to the eye (the most common cause in younger people).
Bleeding inside the eye can come from:
- Abnormal blood vessels which grow because the back of the eye is short of oxygen. These are fragile and bleed easily. Conditions in which this can occur include:
- Normal blood vessels which are damaged. They may be damaged by:
- Posterior vitreous detachment, often because it causes a retinal tear (see below).
- Retinal macroaneurysms – swollen blood vessels on the retina, usually related to high blood pressure, atherosclerosis and smoking.
- Blunt trauma – suddenly compressing the eye – for example, if hit by a squash ball.
- Penetrating trauma – this will cause bleeding throughout the eye. Penetrating trauma can occur from high-velocity injuries such as grinding and hammering. They do not always cause severe eye pain.
- Subarachnoid haemorrhage, which can increase the pressure in the veins in the retina, causing them to bleed.
- Surgery to the eye, particularly if it involves the inside of the eye.
- Blood from behind the retina tracking through into the eye. This is the least common cause of vitreous haemorrhage. It may result from:
- Tumours of the back of the eye (eye tumours are rare. The most common type is ocular melanoma).
- Fragile new blood vessels behind the retina.
Posterior vitreous detachment is usually experienced between the ages of 60 and 80 – it happens to most of us between those ages. It occurs when the vitreous pulls away from the retina at the back. This can happen quite suddenly as the vitreous tends to shrink with age. Most commonly there are no symptoms. Sometimes posterior vitreous detachment causes bleeding from the retina as it pulls away. Sometimes the retina is torn as the vitreous pulls away from it – in this case bleeding is more likely.
Most people experience posterior vitreous detachment in their 60s or later, and most do not have significant vitreous haemorrhage when it happens. However, episodes of noticeable floaters are very common and are probably caused by tiny bleeds.
What are the symptoms of vitreous haemorrhage?
The symptoms of smaller bleeds (most bleeds are smaller bleeds) are of floaters, cobwebs, haze and shadows in the eye. There may be a red tint to the vision. Symptoms most commonly affect one eye only, although both eyes can be affected.
More severe bleeds cause haziness of vision, sometimes with blind spots or dark streaks.
The most severe bleeds cause visual loss, which can be complete, leaving the vision hazily red or black. For most people this is extremely alarming, particularly as it tends to come on very quickly with no clear explanation.
How is vitreous haemorrhage diagnosed?
You will normally be examined with a slit lamp, a device used by opticians and ophthalmologists to look in detail at the inside of the eye. The slit lamp will allow the examiner to see if there is blood in the vitreous.
Finding the source of the bleeding may be possible with the slit lamp, although if there is a lot of blood in the vitreous humour this prevents a clear view and it may therefore be difficult to know what has happened. In this case you may have an ultrasound scan of your eye. Ultrasound can detect many causes of vitreous haemorrhage, including posterior vitreous detachment, retinal tears and detachments, tumours and foreign objects.
Sometimes an angiogram is needed. This test shows up the blood vessels in the back of the eye. This can be helpful if looking for abnormal blood vessels such as in diabetes.
Computerised tomography (CT) scanning of the eyes is useful if there is a suspicion of a penetrating injury.
What is the treatment for vitreous haemorrhage?
The treatment of vitreous haemorrhage varies with the cause. Aims of treatment are to:
- Find the source of the bleeding.
- Stop the bleeding.
- Repair any damage to the retina before it results in permanent loss of vision.
- Restore normal vision.
Once the source of the bleeding has been identified, treatment will depend on the cause. If there is not too much blood in the vitreous and the source of bleeding can be seen then it is treated. This means laser treatment to bleeding vessels and any other abnormal vessels, and repair to any tears in the retina. After this it is a matter of waiting for the blood to slowly clear. This can take several weeks.
You will be advised to avoid strenuous activity for several days at least, as this might dislodge clots and trigger new bleeding. You are also advised to sleep with the head of your bed elevated, as this allows the blood in the vitreous to settle into the bottom of the eye, out of the line of vision.
If the blood in the vitreous obscures the view and prevents treatment of the bleeding then the entire vitreous may be removed first. This procedure is called a vitrectomy. Doctors will perform a vitrectomy if they can’t see the back of the eye, or if the view isn’t good enough to treat the bleeding there safely.
Laser photocoagulation is the usual treatment for fragile abnormal vessels. Treating them both stops the bleeding and prevents later bleeding. Laser photocoagulation is also used in repairing damage to the retina, including retinal detachments.
Anti-VEGF injections aim to shrink abnormal new vessels which have formed in the eye. They are sometimes used in patients with diabetes, in addition to other treatments like laser photocoagulation and vitrectomy, in order to reduce bleeding.
Cryotherapy is also used as a treatment for retinal tears and retinal detachments.
Vitrectomy is removal of the vitreous humour completely, together with the membrane that surrounds it. This is done when there is so much blood in the vitreous that it is impossible to diagnose and treat the cause. Vitrectomy is also sometimes performed if the blood in the vitreous is clearing very slowly and vision remains impaired.
Waiting is commonly the chosen option once the bleeding has stopped. Most cases of vitreous haemorrhage do not require vitrectomy. The blood clears slowly from the vitreous, allowing light to pass through it again. If the underlying vision is undamaged then normal vision will be restored.
If you experience a vitreous haemorrhage then you will usually be seen by a specialist on the same day. This is because sudden loss of vision is considered an eye emergency. The aim is to ensure accurate diagnosis and to avoid permanent loss of vision which could occur if there is a retinal detachment behind the bleeding.
If you have had a vitreous haemorrhage there are some things you can do yourself:
- See your GP or optician, or attend an accident and emergency department, as soon as you reasonably can.
- Try to remain calm – this is easier to say than do when you have just lost vision, but remember that most vitreous haemorrhage responds well to treatment and there is a very good chance your vision will return to where it was.
- Rest for a few hours a day sitting upwards and elevate your head at night on pillows.
- Ask your GP to check your blood pressure – raised blood pressure increases the chance of further bleeding.
- Avoid any heavy lifting, which can increase the chance of further bleeding.
What is the outlook for vitreous haemorrhage?
The outlook (prognosis) in vitreous haemorrhage depends both on the cause and on the severity. Vitreous haemorrhage resulting from posterior vitreous detachment usually has a good prognosis, with restoration of vision, particularly if the eye is otherwise normal. Where severe diabetic eye disease or macular degeneration has resulted in abnormal blood vessels, the outlook for the vision is much less good. The outlook in penetrating eye injury is often poor.
How is vitreous haemorrhage prevented?
Prevention of vitreous haemorrhage involves preventing the underlying causes. This includes careful and regular management of diabetic eye disease (which tends to be worse in less well-controlled diabetes) and high blood pressure, and giving up smoking.
The eye should always be protected from trauma during high-risk activities such as filing, grinding and hammering, using firearms and playing sports with high-speed balls, such as squash.
A subconjunctival hemorrhage occurs when a blood vessel breaks open in the white of the eye. It causes a bright red patch in the white of the eye. It’s similar to a bruise on the skin. This type of hemorrhage is common. It can look quite alarming, but it’s usually harmless.
Understanding the conjunctiva
The conjunctiva is the thin, skin-like layer that covers the inside of the eyelids and the surface of the eye. It has many tiny blood vessels that bring oxygen and nutrients to the eye. The sclera is the white part of the eye that lies beneath the conjunctiva. Sometimes a blood vessel in the conjunctiva breaks open and bleeds. The blood then collects under the conjunctiva and turns part of the eye red. Over several weeks, your body then absorbs the blood.
What causes subconjunctival hemorrhage?
In many cases, the cause isn’t known. But some health conditions may make it more likely. These include:
High blood pressure
Inflammation of the conjunctiva
Contact lens use
Tumor of the conjunctiva
Diseases that affect blood clotting
Violent sneezing, coughing, or vomiting
Certain medicines that can increase bleeding, such as aspirin or blood thinners
Pushing hard during childbirth
Straining during constipation
Symptoms of subconjunctival hemorrhage
The main symptom is a red patch on the eye. You may notice it after waking up in the morning. In most cases just one eye will have a hemorrhage. It usually happens once and then goes away. But some health conditions may cause repeat hemorrhages. You may feel like you have something in your eye, but this is not common. The hemorrhage shouldn’t affect your eyesight or cause any pain. If you do have pain, you may have another type of problem with your eye.
Diagnosing subconjunctival hemorrhage
Your healthcare provider will ask about your health history. You may have a physical exam. This includes a basic eye exam. Your provider will make sure you don’t have other causes of red eye that may need other treatment.
You will need to see an eye doctor (ophthalmologist) if you have had an eye injury. This doctor might use a special lighted microscope to look closely at your eye. This helps show the doctor if the injury hurt the eye itself and not just its outer layer.
If this is not your first subconjunctival hemorrhage, your doctor may need to find the cause. For example, you may need blood tests to check for a blood clotting disorder.
Treatment for subconjunctival hemorrhage
In most cases you will not need treatment. The red patch will usually go away on its own in a few days to a few weeks. It will turn from red to brown and then yellow. There are no treatments to speed up this process. Your healthcare provider may suggest using artificial tears eye drops to help relieve any eye irritation.
If your subconjunctival hemorrhage was caused by a health condition, that condition will be treated. For example, you may need a blood pressure medicine to treat high blood pressure.
When to call your healthcare provider
Call your healthcare provider right away if you have any of these:
Subconjunctival haemorrhage | Health Navigator NZ
Subconjunctival haemorrhage is the medical name for bleeding in the white of your eye. Although this can look serious, it is usually harmless.
- Subconjunctival haemorrhage creates a bright red patch in your eye. It usually causes no other symptoms and doesn’t affect your vision.
- It’s caused by bursting of the tiny blood vessels that run in between the clear surface (the conjunctiva) and the white (the sclera) of your eye.
- No treatment is needed and it will clear itself in about 2 weeks.
- See your doctor if this keeps recurring, or if you haven’t had your blood pressure checked in a while, if you have bleeding in other parts of your body or if you think an eye injury might have caused the bleeding.
What are the causes of subconjunctival haemorrhage?
There are many blood vessels that run in between your conjunctiva (the clear surface of your eye) and sclera (the white of your eye). Subconjunctival haemorrhage happens due to some of these tiny blood vessels bursting and bleeding.
In most cases, there isn’t a clear cause, but causes can include:
What are the symptoms of subconjunctival haemorrhage?
Bleeding in the white of your eye usually causes no symptoms other than the red patch. Occasionally, you can feel some mild irritation. It doesn’t affect your vision as the central part of your eye is not affected.
How is subconjunctival haemorrhage treated?
No treatment is needed. It will clear itself in about 2 weeks. However, see your doctor if you:
- haven’t had your blood pressure checked recently
- think an eye injury or a flying object caused it
- have bleeding in other parts of your body
- keep having recurrent subconjunctival haemorrhages.
Subconjunctival haemorrhage HealthInfo Canterbury, NZ
Subconjunctival haemorrhage Patient Info, UK
What is a subconjunctival haemorrhage? American Academy of Ophthalmology, US
- Unilateral red eye Auckland Regional HealthPathways, NZ, 2019
- Subconjunctival haemorrhage Patient Info, UK
|Dr Divya Perumal works at the Eye Institute and Auckland public hospital. She has expertise in performing eye surgery, including advanced glaucoma surgery and cataract surgery. She is a senior lecturer at the University of Auckland and is actively involved in teaching junior doctors and research, as well as conducting public lectures.|
Diabetic retinopathy – NHS
Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated.
However, it usually takes several years for diabetic retinopathy to reach a stage where it could threaten your sight.
To minimise the risk of this happening, people with diabetes should:
- ensure they control their blood sugar levels, blood pressure and cholesterol
- attend diabetic eye screening appointments – annual screening is offered to all people with diabetes aged 12 and over to pick up and treat any problems early on
How diabetes can affect the eyes
The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical signals. The signals are sent to the brain which turns them into the images you see.
The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels in 3 main stages:
- background retinopathy – tiny bulges develop in the blood vessels, which may bleed slightly but don’t usually affect your vision
- pre-proliferative retinopathy – more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye
- proliferative retinopathy – scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina, this can result in some loss of vision
However, if a problem with your eyes is picked up early, lifestyle changes and/or treatment can stop it getting worse.
Read about the stages of diabetic retinopathy.
Am I at risk of diabetic retinopathy?
Anyone with type 1 diabetes or type 2 diabetes is potentially at risk of developing diabetic retinopathy.
You’re at a greater risk if you:
- have had diabetes for a long time
- have a persistently high blood sugar (blood glucose) level
- have high blood pressure
- have high cholesterol
- are pregnant
- are of Asian or Afro-Caribbean background
By keeping your blood sugar, blood pressure and cholesterol levels under control, you can reduce your chances of developing diabetic retinopathy.
Symptoms of diabetic retinopathy
You won’t usually notice diabetic retinopathy in the early stages, as it doesn’t tend to have any obvious symptoms until it’s more advanced.
However, early signs of the condition can be picked up by taking photographs of the eyes during diabetic eye screening.
Contact your GP or diabetes care team immediately if you experience:
- gradually worsening vision
- sudden vision loss
- shapes floating in your field of vision (floaters)
- blurred or patchy vision
- eye pain or redness
These symptoms don’t necessarily mean you have diabetic retinopathy, but it’s important to get them checked out. Don’t wait until your next screening appointment.
Diabetic eye screening
Everyone with diabetes who is 12 years old or over is invited for eye screening once a year.
Screening is offered because:
- diabetic retinopathy doesn’t tend to cause any symptoms in the early stages
- the condition can cause permanent blindness if not diagnosed and treated promptly
- screening can detect problems in your eyes before they start to affect your vision
- if problems are caught early, treatment can help prevent or reduce vision loss
The screening test involves examining the back of the eyes and taking photographs. Depending on your result, you may be advised to return for another appointment a year later, attend more regular appointments, or discuss treatment options with a specialist.
Read more about diabetic eye screening.
Reduce your risk of diabetic retinopathy
You can reduce your risk of developing diabetic retinopathy, or help prevent it getting worse, by:
- controlling your blood sugar, blood pressure and cholesterol levels
- taking your diabetes medication as prescribed
- attending all your screening appointments
- getting medical advice quickly if you notice any changes to your vision
- maintaining a healthy weight, eating a healthy, balanced diet, exercising regularly and stopping smoking
Read more about how to prevent diabetic retinopathy.
Treatments for diabetic retinopathy
Treatment for diabetic retinopathy is only necessary if screening detects significant problems that mean your vision is at risk.
If the condition hasn’t reached this stage, the above advice on managing your diabetes is recommended.
The main treatments for more advanced diabetic retinopathy are:
- laser treatment
- injections of medication into your eyes
- an operation to remove blood or scar tissue from your eyes
Read more about the treatment of diabetic retinopathy.
Page last reviewed: 30 October 2018
Next review due: 30 October 2021
The conjunctiva is the clear membrane covering
The conjunctiva covers many small, rather
This appears as a
Raising the pressure inside the conjunctival
Most of the time there are no symptoms, however
No treatment is needed in this condition! What
90,000 Hemorrhage in the eye – causes and treatment
In this article we will tell you:
Hemorrhage in the eye can indicate serious problems with the organ of vision. Many ignore the disease, hoping that the hematoma will resolve itself. The danger lies in the fact that hemorrhage can be the result of diseases, both of the organ of vision and the body as a whole. Therefore, if a hematoma occupies a significant space, diverges throughout the eye, causing pain, other unpleasant phenomena, increased tearing or a feeling of pressure, visual impairment, you should consult an ophthalmologist as soon as possible.
Causes of eye hemorrhage
Hematomas appear due to a violation of the integrity of the vessels of the eyeball and arise for various reasons. Moreover, bleeding can affect various formations: sclera, conjunctiva, retina, vitreous body.
Among the most common causes of bleeding in the eye are:
- Sleepless night. Sleep is essential for the whole body, including the eyes. During sleep, the eyelids close, the membrane is protected by the tear fluid.With a lack of sleep, vessels on the sclera often burst, itching or stinging occurs. Such hemorrhages are safe for eyesight.
- Dry eye syndrome. It is accompanied by dryness, cuts, minor hemorrhages. It manifests itself with a deficiency of vitamin A, taking oral contraceptives or diseases of the lacrimal glands (blockage, autoimmune lesions of Sjogren’s disease).
- Increased intracranial pressure. An increase in blood pressure in hypertensive crises can cause one of the most dangerous hemorrhages – into the retina.In this case, patients experience blurred vision.
- Infectious diseases (leptospirosis, hepatitis). Leptospirosis can cause hematomas in the conjunctiva and sclera. With hepatitis, the liver function is disturbed – the regulation of blood coagulation, the synthesis of coagulation factors.
- Diseases of the liver and pancreas.
- Inflammatory processes: conjunctivitis, iridocyclitis, episcleritis, allergies.
- Taking drugs that reduce blood clotting (anticoagulants, antiplatelet agents).
- Injury or surgery, childbirth. In severe labor, there is a risk of retinal detachment and bleeding.
- Vascular lesions in rheumatoid diseases (vasculitis).
- Diabetes mellitus.
- Deficiency of vitamin K, calcium, hemophilia.
If the cause is vascular disease, then hemorrhages in the eye appear with the development of the disease. In the first stages, they are small, but over time, more and more vessels burst and hematomas can be quite large.This can often be seen in patients with atherosclerosis and hypertension.
But it is not always the disease that is the cause of the bleeding in the eye. It can be triggered by heavy physical activity, playing sports, childbirth in women, and even a severe cough.
Whatever the reason for this phenomenon, during a hemorrhage, you should consult an ophthalmologist as soon as possible.
Types and differences of eye hemorrhage
Depending on the place of localization of bleeding, there are several types of disease:
- Retinal hemorrhage is the most dangerous type of disease.After all, the retina is the shell of the eye that perceives light and transmits impulses further to the brain, thanks to which we see images. Blood not only prevents light from reaching the retina, but also has a toxic effect on its structure and function. All this leads to significant, sometimes irreversible loss of vision. Such hemorrhages are the most difficult to treat.
- Scleral hemorrhage is the most common type of disease. Its symptoms are pronounced. The reason may be injuries, pressure surges, fragility of blood vessels.Such hematomas are superficial, usually do not carry a threat and go away without intervention within a few days.
- Hemorrhage into the eye cavity is a case requiring immediate medical examination. May manifest as slight blurred vision. The patient often sees a “cobweb” before his eyes. Failure to do anything can result in significant loss of vision. A small hemorrhage in the eye cavity can resolve on its own, but a serious hematoma requires medical or surgical treatment to restore the normal functioning of the organ of vision.
Symptoms of eye hemorrhage
The disease manifests itself in different ways, depending on which part of the eye has a hemorrhage. Regardless of how much blood is released into the retina, the symptoms of this disease are not always pronounced.
With hemorrhage, redness of the eye is observed and other symptoms appear:
- The patient’s vision deteriorates, the sharpness of perception decreases.The picture becomes less clear, dark spots or “flies” appear before the eyes. If the bleeding is significant, the consequences can be very serious, up to loss of vision.
- With hyphema (hemorrhage in the anterior chamber of the eye), in most cases there is no loss of visual quality. But with heavy bleeding, the pupil may close. This leads to limited vision. After complete removal of the hematoma, it is restored.
- If there is a significant outflow of blood into the vitreous, the consequences can be serious, including loss of vision.Patients diagnosed with hemophthalmos complain of flashes of light or dark spots that constantly move before their eyes.
- In some cases, if the disease is caused by the development of vasculitis, symptoms such as bulging (exophthalmos) occur. The motor functions of the eye are impaired due to the fact that the eyeball is pushed forward.
To diagnose the disease, the ophthalmologist, examining the eye, assesses the nature and extent of the hemorrhage.An ultrasound examination is also carried out to determine the degree of hemorrhage and to prescribe an effective treatment.
Treatment of eye hemorrhage
Since the causes of hemorrhage can be different, then the treatment is also prescribed individually, depending on the factors that caused it. Of course, the first symptoms require immediate consultation with an ophthalmologist. Depending on the clinical case and the complexity of the disease, the patient may be prescribed hospital treatment.Bed rest is often recommended. The main task in treatment is to stop the hemorrhage, and after that, therapy is carried out to resorb blood clots.
- If a patient has a slight hemorrhage caused by rupture of blood vessels, after a while a decrease in the hematoma is observed (several hours), this indicates that the damage is not severe and the hematoma will quickly go away. This usually happens if a vessel bursts during overvoltage (for example, playing sports). Such a hemorrhage does not require special treatment.
- If the hemorrhage is small and resolves on its own after a few hours, but appears regularly, it is recommended to consult a doctor, since there is a problem with the organs of vision or blood vessels. If left untreated, it will only get worse.
- Eye bleeding should not be taken lightly as it can cause complications. Blood cells that break down produce toxic substances. In the early stages of hemorrhage, they can damage the cornea, and in the later stages, they can lead to the development of retinal detachment.
It is not recommended to self-medicate and use folk methods. Various rinses, lotions and other traditional medicine tips can aggravate the problem. Before starting treatment, you need to find out the cause of the hemorrhage and only after that the appropriate therapy is selected.
Treatment is often limited to conventional drops. But they must be selected correctly for a specific clinical case in order to ensure the maximum effect.
Hemorrhage in the eye can indicate a fairly serious disease, so you should not ignore it. It is recommended to immediately contact an ophthalmologist who will give advice and provide professional medical assistance. This will minimize the risk of consequences that may arise due to untimely treatment or attempts to cure with the help of alternative methods. Therapy is chosen depending on the nature and severity of the hemorrhage. The doctor selects medications individually, depending on the clinical case.
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Hemophthalmos: symptoms, diagnosis and treatment
Hemophthalmus involves the ingress of blood into the vitreous humor of the eye. The cause of the pathology is damage to the retina, its rupture or newly formed vessels, which are characterized by increased fragility in comparison with normal vessels.
Hemophthalmos can be observed in the risk group in patients with diabetes, hypertension, after a heart attack or stroke. Often the disease occurs after 40 years with high cholesterol levels. The fair sex is more likely to develop hemophthalmos of the eye than the stronger sex, and in most cases, hemophthalmos contributes to a complete loss of sensitivity of the visual organ, obtaining a disability group.
What is hemophthalmos, basic information about the disease
Hemophthalmus of the eye is a pathology in which blood clots enter the organ of vision, the essence of the process is the deep saturation of the organ with blood.On the third day, as a result of extensive hemorrhage, blood hemolysis occurs, hemoglobin leaves the erythrocytes, they become transparent. In this case, hemoglobin falls out in the form of a granular sediment in the vitreous body of the eye.
Hemosiderin, which is formed during the breakdown of hemoglobin, acts as a toxin on the retina, resulting in the formation of clots of connective tissue that are fused to the retina. As a result, irreversible changes in the organ of vision are observed due to a violation of its normal structure and a violation of chemistry.
As clinical manifestations of pathology, shadows with blackness or redness in front of the eyes are observed, the clarity of the picture decreases, and photopsia develops. In order to establish an accurate diagnosis, ophthalmoscopy, visometry, biomicroscopy, tonometry and ultrasound are prescribed. In the case of partial pathology, medical measures are not applied, and for total hemorrhage, treatment of hemophthalmos with an operation is prescribed based on the degree of violation – laser coagulation, vitrhemectomy.
The main causes and categories of pathology
Among the causes of hemophthalmia, it should be noted:
- Injury to the eyeball of the penetrating type;
- severe eye injury;
- hemorrhagic glaucoma;
- arterial hypertension;
- inflammation of various origins of blood vessels or retina;
- diseases of the cardiovascular system.
Hemophthalmos is divided into several types:
- partial – appears when blood gets in from damaged vessels, blood fills the space by no more than 1/3;
- subtotal hemophthalmos – occurs after injury, the volume of hemorrhage exceeds half of the optic organ;
- total hemophthalmus – the blood completely permeates the organ of vision.
If a disease occurs, it is important to consult a doctor in a timely manner for medical help in order to avoid complete blindness, prevent total hemophthalmus, and save the eye.
Signs of hemophthalmos of the eye are determined by the volume of blood that enters the eye, as well as the stage of the pathology and its features. Bleeding can last from a couple of seconds to a day, during which patients notice moving points in front of their eyes, floating fog and other visual effects. The main feature that distinguishes hemophthalmos is a sudden complete cloudiness, as well as black and red shades before the eyes. The level of clarity reduction is directly determined by the fullness of the blood.With extensive bleeding, patients do not even distinguish bright lighting at all.
Most common symptoms
Based on the severity of the disease, the patient feels the following symptoms:
- moving multicolored dots and threads in front of the eyes;
- decreased vision, loss of sharpness, while vision improves in the morning only after waking up. This fact is explained by the fact that during a long stay in a horizontal position, blood is collected in the lower compartment of the organ of vision;
- Significant visual impairment when the patient does not see objects, but distinguishes only between the dark and the daytime.
In the case of small hemorrhages, the clarity of vision in patients decreases insignificantly, and ganglion cells against the background of retinal detachment provoke the development of photopsies. Noticeable pain is present in the case of hemophthalmos of the eyes after significant trauma or iatrogenism.
Stages of development of pathology
Consider the stages of development of the pathological process:
- fresh hematoma (up to 2-3 days) – signs of phagocytosis, when the patient notices shadows and fogs before the eyes due to the formation of blood clots;
- 3-10 days – hemolysis of erythrocytes, that is, hemoglobin and its derivatives pass into the eyeball, as a result of which vision is significantly reduced.When toxic substances are released, painful sensations and general weakness are felt that accompany hemophthalmus;
- from day 10 – an irreversible process of dystrophy of all elements of the visual organ. Within six months after the first symptoms, a person completely loses his sight, eye problems cannot be restored even through surgical treatment of the eyes and performing an operation on modern equipment. The last stage is atrophy of the eyeball, after which the patient receives a visual disability group.
Diagnostics: how it goes, the procedures used
Diagnosis of hemophthalmos is based on the following techniques:
- indirect binocular ophthalmoscopy with punching – makes it possible to examine the peripheral zones of the retina, to confirm retinal damage and hemophthalmos, as evidenced by the visualization of mplanocytes;
- ophthalmoscopy – allows you to examine the retina in more detail and identify the size of the lesion;
- visometry – allows you to measure the clarity of visual perception, at different stages of pathology it varies from a slight decrease in acuity to a complete nondiscrimination of light, which is characteristic of total hemophthalmus;
- biomicroscopy – the method is used to identify melanocytes and the anterior zone, foci of bleeding;
- ultrasound B-scan – an indication for this diagnostic method is a decrease in the transparency of the organ of vision, which is provoked by darkening of the cornea or cataract.The technique makes it possible to see injuries or foreign bodies, blood clots, to identify adhesion or detachment of the retina, vitreous body of the eye. The B-study mode allows you to determine melanoma, examine the back wall of the eye.
Also, when detecting hemophthalmus, it is necessary to prescribe the patient tests: a general blood test, a coagulogram to detect coagulability, glucose content, and the latter indicator is clearly increased in patients with diabetes in the last stage.
In the process of diagnosis, the attending physician collects anamnesis, patient complaints, examines, prescribes tests to confirm the exact diagnosis.The ophthalmologist examines the entire condition of the eye, retina, and cornea. In the process of collecting anamnesis and choosing a treatment method, it is important to collect complete information about concomitant diseases and pathologies that could provoke the causes of this eye disease.
Which doctor should I contact
In case of eye problems, patients should promptly seek qualified help from an ophthalmologist. Methods for the treatment of hemophthalmos are determined after the initial admission, examination and receipt of laboratory test results.With minor bleeding, the doctor prescribes preventive measures.
Conservative treatment consists in the use of plasminogen activators, and in the period from 3 to 28 days after the hemorrhage has occurred, it is recommended to take prourokinase. Subtotal and complete hemophthalmos requires surgical intervention – vitrhemectomy is performed. In case of damage to the retina, a coagulation technique using a laser apparatus is most often prescribed.
Observing before the eyes multi-colored flies, shadows, fog against the background of the general sweetness of the body, it is necessary to immediately consult a doctor, since when delayed, pathology can cause complete loss of vision.
Doctors of the clinic of JSC “Medicine” in Moscow have many years of practice, confirming their qualifications, therefore, they carry out qualified diagnostics and treatment of hemophthalmos using modern equipment. The cost of the initial appointment and consultation must be checked with the managers of the clinic, who will book you at a convenient time for a visit to the ophthalmologist. The decision on a specific method of surgery and taking medications is made only by a qualified ophthalmologist after a thorough examination of the patient, obtaining the results of a blood test, and carrying out diagnostic measures using high-precision equipment of the medical center.
Upon confirmation of hemophthalmos of the eye, outpatient treatment for a partial illness or inpatient treatment in case of a complete illness is prescribed. With subtotal and complete eye pathology, treatment is practically the same.
Conservative methods of treatment
Conservative techniques involve the use of such measures:
- on the first day, you need to apply cold to the eyes, which will reduce manifestations, narrow the eye vessels;
- eye drops and injection of drugs with calcium chloride, B vitamins in order to reduce the volume of bleeding;
- medications that absorb blood clots for 1-2 days (potassium iodide, lidase, lekozyme, streptodecase), which reduces the visible signs of hemophthalmos;
Partial hemophthalmus implies a favorable prognosis, with total pathology in front of our eyes, the outcome depends on the timeliness of contacting a specialist, the speed of application of measures. That is, the earlier the patient addresses and begins to treat the hemophthalmus of the eye, the more favorable the doctors’ predictions.
In the case when conservative methods of treating hemophthalmos do not bring success for 1-2 weeks, that is, the volume of hemorrhage does not decrease, perception of visual images and eyes are not restored, it is necessary to remove blood clots with a laser.Using the laser technique, it is possible to remove neoplasms from the eye without affecting the eyeball and cornea, while selectively acting exclusively on hemoglobin.
If the doctor diagnoses total hemophthalmos, surgery is inevitable. Moreover, modern techniques make it possible to treat hemophthalmus on an outpatient or inpatient basis, the rehabilitation period after surgery is minimal. Postoperative measures include bed rest, and a sterile bandage is applied to the eyes after surgery.To increase the efficiency of the operation and to avoid relapses, the intake of calcium, vitamins C, B2, BB, dicinone and vicasol is prescribed.
To prescribe an operation, the doctor needs to establish the underlying causes of the pathology, because it is on the successful elimination of hemorrhage that the success of the treatment depends, the complete restoration of the eye and vision. If tears or damage to the retina are detected, laser coagulation or cryocoagulation is performed. As an alternative technique, injections into the eyes of drugs that inhibit the formation of blood vessels (Avastin, Lucentis) are used.If hemophthalmos is accompanied by retinal detachment, immediate surgery is prescribed.
Vitrectomy is used as a treatment by which intraocular bleeding is removed and hemophthalmos is treated. During this operation, the vitreous body of the eye is completely or partially removed, the reasons for surgical intervention are:
- detachment of the retina;
- bleeding inside the optic organ, which occurs for 2-3 months;
- bilateral hemophthalmos, suspicion of extensive pathology by the doctor.In diabetic babies, this avoids amblyopia;
- hemophthalmos in combination with concomitant ocular pathologies.
With an immediate visit to a doctor, when the patient discovers the first signs of the disease, the chances of a favorable outcome of treatment, restoration of the eye and visual acuity increase.
Indications for disease
After bleeding into the eyes, patients need to limit physical activity and stay in bed to avoid further aggravation of the pathology.Hemophthalmus suggests that for blood to accumulate in the lower part of the optic organ, it is required to lie horizontally, while the head should be raised 35-40 °.
During prevention and treatment, it is necessary to exclude the use of medications that contribute to blood thinning (aspirin, anticoagulants), provoke further hemophthalmus. If the attending doctor prescribed them earlier due to the fact that hemophthalmus was accompanied by a concomitant disease, it is required to weigh the risks of discontinuing the drug and the positive effect of taking it.
The prognosis of treatment is determined by the cause of the pathology, the timeliness of the visit to the doctor, the correct selection of the surgical procedure and whether the operation was performed correctly.
Contraindications for disease
Hemophthalmus means that at any stage of the disease, the following are completely contraindicated:
- physical activity;
- weight lifting;
- drinking alcohol, smoking.
90,015 classes in the gym, dancing;
These factors can significantly aggravate hemophthalmus, provoke additional stress on the eyes and blood vessels, which can cause repeated bleeding and relapses after the operation has been completed.
The cost of initial admission, research, treatment
Patients diagnosed with hemophthalmus or suspected of having this disease can undergo an initial appointment at the clinic of Medicina JSC. Qualified ophthalmologists will conduct an eye examination, diagnostics using modern devices and prescribe the appropriate medication or surgical treatment.
At the reception, the ophthalmologist, by examining the vitreous body of the eye, the cornea, draws conclusions about how much hemorrhage the patient has and how to treat hemophthalmus at a particular stage. The cost of appointments and treatment can also be clarified with specialists by phone or directly at the clinic.
Benefits of treatment in the clinic of JSC “Medicine”
At Medicina JSC (Academician Roitberg’s clinic), patients with suspected hemophthalmos can undergo qualified treatment on an outpatient basis or in a comfortable hospital.The clinic employs ophthalmologists who have significant experience in the treatment of various diseases of the vitreous body, cornea, and retina.
If a doctor prescribes an operation, the intervention is carried out using modern laser equipment, which minimizes the rehabilitation period. During the treatment of the eyes, patients stay in the hospital, where comfortable conditions are provided, which allows them to completely cure hemophthalmus, prevent the occurrence of relapses in the future.
Intraocular bleeding | Institut de la Màcula
Intraocular or vitreous hemorrhage is the presence of hemorrhage in the inner area of the eye, called the vitreous cavity .The vitreous body is a jelly-like and transparent substance that occupies two-thirds of the total volume of the eye, 99% consists of liquid, its back part borders on the retina, and its front part – on the lens and ciliary body.
If hemorrhage occurs in the vitreous body, it loses its transparency and ceases to transmit light, which causes loss of vision.
There are many causes of vitreous hemorrhage, most of them are spontaneous, and they can also be the result of trauma.The most common cause is diabetic retinopathy (50% of cases), followed by rhegmatogenous retinal detachment, posterior vitreous detachment, and central retinal vein obstruction. These causes account for 95% of cases of spontaneous bleeding.
The main symptom is a sudden loss of vision that develops within a few minutes. Depending on the intensity of bleeding, loss of vision can be complete or partial.
Sometimes, if the hemorrhage is light, then it appears only in blurry vision.
Due to the fact that the causes of this phenomenon are very extensive, there is no one way of treatment for all patients. It should be individual, based on the causes of the hemorrhage, its severity, and personal circumstances.
If the hemorrhage is minor, then it may resolve on its own, for which only time is needed, although the full restoration of vision may take several months.
In other cases, over time, a surgical procedure called vitrectomy is recommended, which consists in removing the vitreous body by means of micro-incisive surgery.
Depending on the cause of the bleeding, it may be necessary to add some more treatments such as laser or intravitreal injections.
90,000 What to do in case of bleeding in the eye
Damage to small blood vessels in the eye causes redness or hemorrhage.
Depending on the location of the damaged vessel, there are:
– subconjunctival hemorrhage. The vessels of the mucous membrane of the eye are damaged. They are usually spontaneous and develop for no apparent reason.
– Hyphema. Hyphema is a collection of blood in the anterior chamber of the eye (between the cornea and the iris). It is usually the result of blunt trauma to the eye. It is accompanied by severe pain and blurred vision. This bleeding in the eye requires emergency treatment.
– Hemophthalmos. Vitreous hemorrhage inside the eye. In other words, internal bleeding in the eye. With hemophthalmos, a pronounced fog appears in front of the eye. In the case of complete hemophthalmos, vision loss occurs. Hemophthalmus is a severe lesion of the eye. Irreversible loss of vision is possible without treatment.
– Retinal hemorrhage. Retinal hemorrhage develops as a result of bleeding from the retinal vessels. The retinal tissue is very delicate and delicate. Therefore, even small hemorrhages can lead to significant loss of vision and the development of retinopathy.
Symptoms of hemorrhage in the eye
Subconjunctival hemorrhage. Usually, besides severe local redness of the eyes, there are no other symptoms. Very rarely, in case of damage to a large vessel, pain may appear. With extensive hemorrhage, a feeling of pressure in the eye may appear.
The very site of hemorrhage in the eye – has a bright red color, clear boundaries. In the case of extensive bleeding in the eye, the blood spreads to the entire tunica albuginea.
Causes of hemorrhage in the eye
There are the following reasons for the appearance of this symptom:
– Eye trauma.
– Inflammation of the mucous membrane of the eye caused by viruses.
– Sudden and rapid increase in blood pressure.
– Severe cough, vomiting.
– Taking medications that thin the blood (aspirin, salicylates, anticoagulants).
– Vitamin K deficiency.
– Blood clotting disorder.
– General diseases: Diabetes mellitus, Hypertension, systemic vasculitis.
– After eye surgery.
When should I see a doctor urgently?
See a doctor immediately:
– hemorrhage happened simultaneously in 2 eyes at once
– sudden loss of vision in one or two eyes
– heavy fog in the eye
– hemorrhage is accompanied by pain and decreased vision
– bleeding in the eye happened as a result of an eye injury
– you are taking blood thinners
How to treat bleeding in the eye
Subconjunctival hemorrhage in most cases does not require treatment and goes away on its own.
In case you experience pain and discomfort, your doctor may prescribe decongestant and anti-inflammatory drops. For concomitant eye infections, antibacterial or antiviral drugs are prescribed. As a rule, subconjunctival hemorrhage resolves in 2 weeks, without complications.
In other cases of bleeding in the eye, immediate treatment in an eye hospital is required.
What should not be done categorically?
If bleeding occurs in the eye, you should not:
– rub your eyes, this increases the bleeding
– instill eye drops without a doctor’s prescription
– put on contact lenses
– you should not stop taking medications yourself if you are taking medications blood thinners, tell your GP about the occurrence of hemorrhage.
What happens if the symptom is not treated?
Only subconjunctival hemorrhage can pass on its own without consequences for your vision and health.
In other cases, if left untreated, complete and irreversible loss of vision is possible. The appearance of such a symptom indicates a serious problem with the eyes or the whole body.
Prevention of hemorrhage in the eye
There are no specific measures to prevent the development of hemorrhage in the eye.If you have frequent hemorrhages, be sure to undergo an examination with a therapist to find out the cause.
Treating an underlying medical condition, such as diabetes or hypertension, can prevent complications such as bleeding in the eye.
Come for diagnostics at the KazNII of eye diseases at the address: Almaty, Tole bi street, 95a (corner of Baitursynov street).
Phone: +7 (775) 007 01 00; +7 (727) 279 54 36.
90,000 symptoms, diagnosis and treatment methods
- Causes of occurrence
Hyphema is bleeding in the anterior chamber of the eye.Its source is the iris, in the tissue of which there are many vessels.
The amount of blood can vary – from an almost imperceptible strip, which can only be seen under a microscope, to filling the entire space of the anterior chamber. Since the blood is heavier than the intraocular fluid, it settles to the bottom. Visual acuity falls, and a pronounced hyphema allows only light to be distinguished.
Causes of occurrence
Experts identify 4 reasons for the appearance of hyphema:
1) Injuries to the eyeball.They can be both penetrating (with damage to all membranes of the eye) and dull (without damage). With penetrating wounds, there is a rupture of the membranes and blood vessels, so blood is poured into the anterior chamber. Bleeding with blunt trauma is explained by a sharp drop in pressure in the eyeball, which violates the integrity of the vessels and membranes (iris, vascular, ciliary body, etc.). Injuries and contusions are the most common causes of hyphema.
2) Operations on the eyeball.Hyphema can be a complication of abdominal or laser surgery. It occurs after damage to the vessels of the iris and the ciliary body. As a rule, such bleeding is stopped during the operation, but hyphema can be fixed for several months. They appear due to the flow of blood from the same vessels as in the operation, and the growth of newly formed vessels where the incision was made.
3) Eye diseases. In severe diabetes mellitus, the consequences of thrombosis of the central retinal vein, tumors of various localization, the growth of vessels in the iris is observed.They have defective walls and burst at the slightest change in blood pressure. This is how bleeding is formed.
4) General diseases of the body. Leukemia, hemophilia, anemia and alcoholism cause bleeding disorders. As a result, bleeding appears for no apparent reason.
Blood in the anterior chamber can cause various complications. When the space is completely filled, the eyes are observed:
- Increasing staining of the cornea with blood, resulting in decreased visual acuity;
- increased intraocular pressure;
- secondary glaucoma.
First of all, it is necessary to establish the cause of the hyphema. Visual acuity and intraocular pressure must be checked. The examination is carried out using an ophthalmoscope and a slit lamp. Hyphema may look like a layer of blood or a clot in the anterior chamber. Microhyphema has the form of a turbidity consisting of frozen red blood cells.
The doctor asks if eye surgeries were performed, if there was any traumatic effect.Computed tomography may be prescribed. It is also investigated whether the patient has taken blood thinning medications. If necessary, coagulation tests are taken.
The choice of treatment method always depends:
- from the cause of hyphema;
- of the duration of the observed hemorrhage.
90,015 the amount of blood in the anterior chamber of the eye;
Most often, blood spontaneously resolves within a few days.This occurs when there is little bleeding.
If the patient took any blood thinning drugs (anticoagulants, antiplatelet agents, etc.), they are temporarily canceled to increase the rate of hyphema resorption. A treatment is prescribed that stops bleeding, strengthens blood vessels, destroys the formed clots and, if necessary, helps in overcoming systemic coagulation disorders.
As a rule, for hyphema, doctors recommend:
- lack of physical stress;
- contacting medical institutions in the event of severe pain in the eyes;
- application of drops prescribed by a specialist;
- Protecting the eyes from new damage with a soft bandage;
- Daily visit to an ophthalmologist if a small layered or microhyphema is detected.
In case of ineffective conservative therapy, large blood volumes and the manifestation of complications, the hyphema is surgically flushed out. Indications for surgery are:
- blood smears on the cornea;
- clot formation;
- complete filling of the anterior chamber with blood;
- persistence of hemorrhage for 5-10 days with treatment;
- increased intraocular pressure.
Approximately 15-20% of patients with hyphema develop even more bleeding within 3-5 days, so it is necessary to follow the doctor’s recommendations exactly. People with this condition may wear a special bandage for up to 2 weeks after the hemorrhage occurs. Also, after traumatic exposure, it is required to undergo an examination every year for the early diagnosis of glaucoma, which can result in damage to the drainage system of the eye chambers.
Dr. Kurenkov’s ophthalmological clinic offers high-quality and timely treatment of hyphema.If you have any questions, please call +7 (495) 781-9333.
90,000 Pediatric neurosurgery. Services of the Clinic “Pediatric Neurosurgery” prof. A.L. Polenova
Cephalohematoma is observed in about 0.5% of newborns. It is characterized by hemorrhage between the flat bones of the skull and connective tissue, expressed as a swelling on the head. Redness may be absent altogether. It happens for the following reasons: when the baby’s head passes through the birth canal, with some violation of the contractile actions of the mother’s uterus and the expulsion process, the bones of the child’s skull are compressed, the skin displaces after the periosteum and the vessels rupture.Further, a certain amount of blood accumulates at the site of the rupture .. The volume of blood in the cephalohematoma ranges from 5 to 150 ml. Usually, the neonatal cephalohematoma is located on one or two parietal bones, rarely on the frontal and occipital, almost never on the temporal part. If the size of a newborn’s cephalohematoma is more than 8 cm3, it must be evacuated. Intracranial hemorrhage. Subdural hematiomas often occur during rapid labor, when there is a sharp displacement of the bones of the skull.The most frequently injured vessels are those that flow into the superior sagittal and transverse sinuses and the vessels of the cerebellar tentorium. Subdural hematomas can be unilateral or bilateral. Immediately after birth, neurological disorders are not pronounced sharply, and this condition is usually diagnosed as a cerebral circulation disorder of the I-II degree. The child’s condition is gradually deteriorating. The resulting hematoma causes compression of the vital centers of the brain, causes dislocation of the cerebrospinal fluid pathways.The skin is pale, cold, rapid breathing, irregular, irregular pulse. Muscle tone is reduced. Unconditioned reflexes are absent or depressed. Corneal and conjunctival reflexes are absent. The baby does not suck or swallow. Symptoms of intracranial hypertension gradually increase, fontanelles swell, and cranial sutures may diverge. There may be focal or generalized clonic-tonic seizures. With an unrecognized hematoma, it is encapsulated after 7-10 days, followed by atrophy of the brain tissue.Neurosurgical treatment. Subtentorial subdural hemorrhages (hemorrhages in the posterior cranial fossa) are particularly severe. From the moment of birth, symptoms of compression of the brain stem increase: stiff neck, anisocoria, persistent aversion of the eyes, gross nystagmus, tonic convulsions. Bradycardia, respiratory distress, lethargy, hypo- and areflexia, sucking and swallowing disorders progress. The severity and prognosis are determined by the timeliness of diagnosis and neurosurgical treatment.A favorable outcome is possible, but with the subsequent appearance of hydrocephalus, minimal cerebral dysfunction. Treatment: with superficial subdural hematoma, the outcome is favorable if surgical treatment is carried out in a timely manner. Epidural hemorrhages Epidural hemorrhages arise from the vessels of the periosteum due to a fracture or fissure of the bones of the cranial vault. Located between the inner surface of the bones of the skull and the dura mater, as a rule, they are combined with an external cephalohematoma.In the clinic, after a “light interval” from 3 to 6 hours, a brain compression syndrome develops – a sharp anxiety, mydriasis on the affected side, convulsions more often of a clonic-tonic nature, hemiparesis on the opposite side, bradycardia, bradypnea up to asphyxia, a decrease in blood pressure. Neurosurgical treatment. If the hematoma is not operated on, the child may die. Subarachnoid hemorrhage is one of the most common types of cerebrovascular accident in newborns.In 75% of cases, subarachnoid hemorrhages are observed in premature babies. The cause of these hemorrhages can be asphyxia, increasing vascular permeability, the application of forceps, a vacuum extractor. Capillaries and small vessels rupture. There are frequent regurgitation, vomiting. Muscle tone is high. Symptoms of increased intracranial pressure appear – divergence of the cranial sutures, tension in the large fontanelle, strabismus. There is a pronounced general hyperesthesia, tremor, stiff neck muscles.With lumbar puncture, blood is detected in the cerebrospinal fluid. Small multiple hemorrhages are more common with prolonged childbirth, premature discharge of water, weakness of labor; they can be found in the hemispheres, cerebellum, brain stem. The cause of multiple petechial hemorrhages is oxygen starvation of the brain. Newborns are restless, their facial expressions are painful, cramps in the muscles of the face and extremities, vomiting, suppression of unconditioned reflexes are noted.This condition can last for several weeks. Subsequently, movement disorders, epileptic seizures, mental retardation are often found. Subpendymal hemorrhages are often the result of rupture of small veins between the caudate nucleus and the optic tubercle. Hemorrhage often destroys the head of the caudate nucleus. There are deep disorders of the functions of the central nervous system, dysregulation of vegetative-trophic functions. When blood breaks through into the lateral ventricle, a picture of intraventricular hemorrhage develops.Intraventricular hemorrhages are common in preterm infants but also occur in term infants. The clinical picture is characterized by depression of consciousness, respiratory distress, tonic convulsions. Children do not suck, do not swallow .. The large fontanelle is tense. Hyperthermia, central disorders of vegetative-trophic functions are characteristic. These hemorrhages can be acute or subacute. For the former, anemia, diffuse muscle hypotonia, tremor, tonic convulsions, a piercing cry, inhibition of sucking and swallowing, oculomotor disorders (open eyes, gaze paresis, vertical nystagmus) are characteristic of anemia, diffuse muscle hypotonia, tremors, growing in periods from several minutes to 2-3 days.With a change in body position, a sharp deterioration in the condition is noted. The subacute course of intraventricular and periventricular hemorrhages is observed in the presence of postnatal causes of hypoxia. They are characterized by repeated apnea, muscle hyper- or hypotension, hyporeflexia, persistent “eye” symptoms (nystagmus, Grefe, “setting sun”, strabismus), pseudobulbar disorders. Convulsive syndrome is observed less often than in acute course. Excessive blood circulation in the brain with an increase in venous pressure is characterized by bulging and tension of the fontanelles.Combinations of various types of hemorrhage are not rare in newborns.Diagnosis of birth hemorrhages is based on a thorough study of the obstetric history, the course of labor, a detailed neurological examination and the use of special research methods ultrasound, CT, MRI of the brain Treatment of a child who has undergone a birth hemorrhage should be comprehensive and continuous from the first days of life. The effectiveness of treatment depends on the early diagnosis of neurological disorders.Treatment of birth hemorrhages in the acute period should be urgent and active and carried out in a specialized hospital. Very important, determining the tactics of treatment, is the consultation of a pediatric neurosurgeon carried out in the first weeks after hemorrhage. Intensive therapy is carried out including dehydration, vascular, anticonvulsant therapy, resorption therapy, sometimes external drainage of the lateral ventricles of the brain with fibrinolysis. With an increase in the size of the ventricular system against the background of a conservative one, cerebrospinal fluid shunting operations are performed.Early and adequate surgical treatment will provide your child with high chances for normal intellectual and physical development.
Abscess of the brain
Malformations of the bones of the skull.
Tumors of the cerebellum
Tumors of the 4 ventricles of the stomach large brain tumors
Tumors of the posterior cranial fossa in children
Tumors of the bones of the skull
Tumors of the spinal cord
Tumors of the brain stem
Injuries of individual peripheral nerves
SKULL AND BRAIN
arterial aneurysms and arteriovenous malformations
Memo for patients
Patients with von Willebrand disease (VWD) have internal and external bleeding.Multiple bleeding in the same joint can lead to damage and pain. Repeated bleeding can cause other conditions, such as arthritis, which makes it difficult to walk or perform other simple activities.
Intra-articular, intramuscular bleeding occurs most often in the indicated areas.
How are patients with BV treated?
BV treatment is currently very effective. Missing coagulation factors VIII and von Willebrand factor are given by injection.When a sufficient amount of clotting factor reaches the damaged area, the bleeding stops.
Treat Bleeding Fast!
Immediate treatment will help reduce pain and damage to joints, muscles and organs. With immediate treatment, less clotting factor is needed to stop bleeding.
If in doubt, heal!
If it seems to you that you have started bleeding, treat it even if you are not sure about it.Never wait for a joint to become inflamed, swollen, and sore. Do not think that the treatment may be “in vain.”
There is no radical cure for BV yet, but with treatment, patients can lead a healthy lifestyle.
Without treatment, patients with severe and type 3 BV may find it difficult to go to school or work regularly. They may become physically disabled, they may have trouble walking or other simple activities, or they may die at an early age.
When should treatment be sought?
Treatment is required in the following cases:
– with intra-articular bleeding;
– with intramuscular bleeding, especially in the arms and legs;
– for injuries to the neck, mouth, tongue, face or eyes;
– with severe head bruises and unusual headache;
– with heavy or persistent bleeding anywhere;
– with severe pain or swelling anywhere;
– for any open wounds that need to be sutured;
– after any accident that may result in bleeding.
Treatment is required before:
– surgery, including dental;
– actions that can cause bleeding.
When may treatment not be needed?
Children with BV often have minor abrasions, but they are usually not serious. However, abrasions to the head can be more serious and should be evaluated by a nurse or doctor with a specialist in BV.
Small cuts and scrapes will bleed for as long as a healthy person.They are usually not dangerous.
Deep cuts will often (but not always) bleed longer than usual. Usually, the bleeding can be stopped by pinching the wound.
Nosebleeds can usually be stopped by pinching the nose for five minutes. If you have severe, prolonged bleeding, you should see a doctor.
What to do if bleeding starts?
BV is a lifelong disease and currently cannot be cured. However, now, when a system of comprehensive care for patients with BV is developing and it is possible to provide drugs containing blood coagulation factors that are missing in this disease, it is possible for patients with BV to control bleeding even with a severe degree of the disease.
When is it necessary to see a doctor immediately?
– After a blow to the head or other head injuries, or when the cause of prolonged headache or nausea and vomiting is unclear.
– Intense bleeding that cannot be stopped without special help or that continues even after first aid.
– When blood appears in the urine or feces.
– When the causes of abdominal pain are not clear.
– When bleeding or pain occurs in the neck.
Which bleeding is serious or life threatening?
The main cause of death in BV, especially in children, is cerebral hemorrhage (usually as a result of trauma). These hemorrhages can cause headache, nausea, vomiting, lethargy, loss of orientation and accuracy of movements, weakness, convulsions, and loss of consciousness.
Hemorrhages in the throat can be caused by infection, injury, dental injection, or surgery.A bleeding in the throat causes swelling and difficulty in swallowing and breathing.
Other hemorrhages – to the eyes, spine, and psoas – can be very serious but are usually not life threatening.
What are inhibitors?
Inhibitors are antibodies (proteins) produced by the body in order to get rid of substances that seem “foreign” to it.
In the blood of a patient with BV, inhibitors can be produced that seek to destroy the foreign protein in the medicinal product.If the inhibitors are stronger, the usual amount of treatment may be ineffective.
Inhibitors are rare. They are most often found in patients with severe BV.
Check for inhibitors before surgery, including dental surgery.
Advantages of home treatment
Home treatment is a clotting factor concentrate transfusion outside the hospital. All treatment records should be kept – keep a transfusion diary.
Home treatment is not only a big responsibility for the transfusion, but also the ability to do it yourself – after all, you yourself treat your bleeding.
The patient with BV and his family members share responsibility for the patient’s health with the healthcare professionals. Talk to your hematologist before starting home treatment. The hematologist will explain the rules of home treatment, teach you how to correctly determine the dose of the concentrate for adequate treatment of bleeding, the nurse will help you master the method of access to the vein and explain the technique of transfusion. It is advisable that the family of a patient with BV includes two people who know the technique of transfusion (you and someone close to you).
Who can receive home treatment? These are people with severe von Willebrand disease. It should be noted that home treatment is not a substitute for clinical treatment.
Benefits of home treatment:
– Treatment of bleeding begins quickly, that is, the joints are preserved, this is the key not to turn into a disabled person.
– Travel to the hospital less often.
– If you quickly stop bleeding in the affected target joints, you will not have to endure pain.
– No pain relievers needed.
– No skipping school or going to work.
– Physical and social activity increases.
– Become independent.