Retinal hemorrhage describes the abnormal bleeding of the vessels in the retina. The retina is the inside surface of the back of the eye, consisting of millions of dense, light-sensitive cells called rods and cones. Blood flow to the retina is maintained by the retinal vein and artery, and a dense network of small capillaries supply the area with circulation.
How does a hemorrhage occur?
The blood vessels around the retina can become damaged by injury or disease and may bleed, causing temporary or permanent loss of visual accuracy. Because the cells of the retina are so dense and sensitive, even small injuries to the blood vessels can translate into vision problems. Diseases such as diabetes and high blood pressure also affect the blood vessels of the eye. Retinal hemorrhages can be caused by injuries, usually forceful blows to the head during accidents and falls, as well as by many health conditions. In infants, retinal hemorrhage is frequently associated with child abuse and has been termed shaken baby syndrome. People with high blood pressure (hypertension) may develop hypertensive retinopathy, where blood vessels in the retina become damaged from increased blood pressure.
What are the symptoms?
Symptoms are typically not pronounced, but blurred or decreased vision may be caused by the leakage of blood. Spotted vision or streaks/lines in the field of vision may also be present.
How is retinal bleeding diagnosed?
Diagnosis is performed by an ophthalmologist, particularly one who specializes in disorders of the retina, such as Dr. Kenneth Sparks. Dr. Sparks may perform an ophthalmoscopy, using an instrument called an opthalmoscope to examine the inside of the eye. For a detailed view of the blood vessels of the retina, a fluorescein angiography test might be performed, in which a florescent dye is injected into the patient's bloodstream and photographs record the status of the blood vessels in the retina. Vision tests, patient history, and blood tests might also be ordered by the diagnosing physician.
What treatments are offered?
Many retinal hemorrhages, especially milder ones not associated with chronic disease, can resorb without treatment. Laser surgery by Dr. Sparks is a common treatment for retinal hemorrhages, in which a laser beam is used to remove or seal off damaged or bleeding blood vessels in the retina. For retinal hemorrhages associated with diabetes and high blood pressure, treating the underlying condition is required and this alone may stabilize the bleeding and lessen the chance of recurrence. For more severe hemorrhages, surgery may be necessary. More recently success has been achieved with injection of anti-VEGF drugs (Avastin / Lucentis) in those cases of hemorrhage associated with new vessel growth. Please call us for more information.