From the Guidelines

Vitreous hemorrhage is a condition where blood leaks into the vitreous humor, the clear gel-like substance that fills the center of the eye.

It is often associated with posterior vitreous detachment (PVD), which is a separation of the posterior vitreous cortex from the internal limiting membrane of the retina 1.
Retinal breaks or tears can also lead to vitreous hemorrhage, as blood from the torn or avulsed retinal vessel can leak into the vitreous humor 1.
Other factors that may contribute to vitreous hemorrhage include trauma, myopia, and ophthalmic surgical procedures 1.

A thorough eye examination is necessary to diagnose vitreous hemorrhage, including confrontation visual field examination, visual acuity testing, and examination of the vitreous for hemorrhage, detachment, and pigmented cells 1.
Indirect ophthalmoscopy with scleral depression is the preferred method for evaluating patients with suspected vitreous hemorrhage, as it allows for a detailed examination of the peripheral retina 1.
B-scan ultrasonography may be used to search for retinal tears or other causes of vitreous hemorrhage if media opacity or patient cooperation precludes an adequate examination of the peripheral retina 1.

The management of vitreous hemorrhage depends on the underlying cause and severity of the condition, but may include observation, vitrectomy, or laser treatment 1.
Early vitrectomy (usually defined as within 7 days of presentation) may be considered to reduce the risk of complications in cases of dense PVD-associated vitreous hemorrhage 1.

From the Research

Vitreous hemorrhage is a condition where blood leaks into or around the vitreous cavity, causing a sudden painless decrease in vision 2, 3, 4, 5.
The most common causes of vitreous hemorrhage include:
- Proliferative diabetic retinopathy
- Vitreous detachment with or without retinal breaks
- Trauma
- Vascular occlusive disease
- Retinal arterial macroaneurysm
- Hemoglobinopathies
- Age-related macular degeneration
- Intraocular tumors 3, 5
Vitreous hemorrhage can also be caused by disruption of normal retinal vessels, bleeding from diseased retinal vessels, bleeding from abnormal new vessels, or extension of hemorrhage through the retina from other sources 2.

Diagnosis of vitreous hemorrhage requires a thorough history taking and clinical examination, including investigations such as ultra-sonography 2, 5.
Treatment options for vitreous hemorrhage include:
- Observation
- Laser photo-coagulation
- Cryotherapy
- Intravitreal injections of anti-vascular endothelial growth factor
- Surgery (pars plana vitrectomy) 3, 5, 6
The prognosis of vitreous hemorrhage depends on the underlying cause, and treatment is directed at the underlying cause 3, 5.

Complications of vitreous hemorrhage include glaucoma, proliferative vitreoretinopathy, and hemosiderosis bulbi 5.
In cases of nondiabetic vitreous hemorrhage, early vitrectomy may be the safest and most appropriate approach, provided the patient accepts procedural risks like cataract development 6.