From the Guidelines
Bleeding to the eye, also known as retinal hemorrhage, is most commonly caused by retinal vein occlusion, which occurs when there is a partial or complete obstruction of a retinal vein, leading to increased intravenous pressure and subsequent hemorrhage. This condition is often associated with vision loss and is classified by the location of the occlusion, with central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) being the most common types 1. The major risk factors for retinal vein occlusion include systemic arterial hypertension, arteriosclerosis, and diabetes, which can cause damage to the blood vessels in the retina, leading to obstruction and subsequent hemorrhage 1.
Some key points to consider when evaluating a patient with bleeding to the eye include:
- The location and extent of the hemorrhage, which can help determine the underlying cause and guide treatment
- The presence of underlying medical conditions, such as hypertension or diabetes, which can increase the risk of retinal vein occlusion
- The patient's age, as retinal vein occlusion is more common in individuals over 40 years of age 1
- The presence of other symptoms, such as vision changes or pain, which can indicate a more serious underlying condition
It is essential to seek immediate medical attention if the bleeding is accompanied by pain or vision changes, covers a large portion of the eye, or if there are recurrent episodes, as these could indicate a more serious underlying condition 1. In general, the prognosis for vision loss due to retinal vein occlusion depends on the degree of nonperfusion and the location of the occlusion, with some patients experiencing spontaneous improvement in visual acuity, while others may require treatment to prevent further vision loss 1.
From the Research
Causes of Bleeding to the Eye (Hemorrhage to the Eye)
- Bleeding to the eye, also known as hemorrhage to the eye, can be caused by various factors, including:
- Neovascular glaucoma secondary to central retinal vein occlusion, as seen in a case where a 72-year-old woman presented with decreased vision and was diagnosed with rubeosis iridis 2
- Retinal vein occlusions (RVO), which are common retinal diseases caused by an obstruction of retinal veins, and can lead to visual deterioration and blindness 3, 4
- Arterial occlusions to the eye, which can result in acute loss of vision and are often caused by atherosclerotic risk factors 5
- Essential idiopathic bilateral haemolacria, a rare condition characterized by spontaneous bloody tears from both eyes without any underlying pathology 6
- These conditions can lead to bleeding in the eye due to various mechanisms, such as:
- Obstruction of retinal veins, leading to increased pressure and bleeding 3, 4
- Neovascularization, where new blood vessels grow in response to ischemia, and can lead to bleeding 2
- Atherosclerotic risk factors, which can cause arterial occlusions and lead to bleeding 5
- Unknown mechanisms, as seen in cases of essential idiopathic bilateral haemolacria 6