Concept

Intraocular hemorrhage

Intraocular hemorrhage (sometimes called hemophthalmos or hemophthalmia) is bleeding inside the eye (oculus in Latin). Bleeding can occur from any structure of the eye where there is vasculature or blood flow, including the anterior chamber, vitreous cavity, retina, choroid, suprachoroidal space, or optic disc. Intraocular hemorrhage may be caused by physical trauma (direct injury to the eye); ocular surgery (such as to repair cataracts); or other diseases, injuries, or disorders (such as diabetes, hypertension, or shaken baby syndrome). Severe bleeding may cause high pressure inside the eye, leading to blindness. Intraocular hemorrhage is classified based on the location of the bleeding: Hyphema (in the anterior chamber) Suprachoroidal hemorrhage (SCH) is a rare complication of intraocular surgery in which blood from the ciliary arteries enters the space between the choroid and the sclera. It is potentially vision-threatening. In the posterior segment of the eyeball: Vitreous hemorrhage (into the vitreous) Subretinal hemorrhage (under the retina) Submacular hemorrhage (under the macula) Another type of ocular hemorrhage is subconjunctival bleeding, which occurs just underneath the conjunctiva. A subconjunctival hemorrhage can often occur without any obvious cause or harm to the eye. A strong enough sneeze or cough can cause a blood vessel in the eye to burst. Hyphema is a result of blunt or penetrating trauma to the orbit that increases intraocular pressure, causing tears in the vessels of the ciliary body and iris. Certain medical conditions—such as leukemia, hemophilia, Von Willebrand disease, and sickle cell disease—put patients at risk of developing hyphema, as does the use of anticoagulant medications. Neovascularization of the eye, often associated with diabetes mellitus, is also a risk factor. People who have undergone surgery (such as for cataracts) may develop hyphema during or up to a week after the surgery. Vitreous hemorrhage can be caused by proliferative diabetic retinopathy, vitreous detachment with or without retinal breaks, and trauma.

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