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# Vitreous haemorrhage

Bleeding into the gel of the eye blurs or blocks vision suddenly. In adults it usually comes from diabetic new vessels or a retinal tear.

Updated Nov 5, 2026

On this page

- The basics What it is
- Who gets it
- Causes
- Risk factors
- Pathophysiology
- Why it happens

- Clinical Symptoms and signs
- Red flags
- Diagnosis
- Differential diagnosis
- Complications
- Prognosis

- Treatment Goal of treatment
- Treatment
- Prevention

- Study Test yourself

- Connections Connections

## What it is

Blood in the [vitreous](https://durgical.com/en/anatomy/vitreous-body/) cavity, which causes sudden floaters, haze or loss of vision without pain. It is a sign of another disease: most often proliferative diabetic retinopathy, a retinal tear during vitreous detachment, a vein occlusion or trauma. The key question is whether a retinal detachment lies behind it.

See it in 3D

- [Vitreous](https://durgical.com/en/anatomy/vitreous-body/)
- [Retina](https://durgical.com/en/anatomy/retina/)
- [Optic disc](https://durgical.com/en/anatomy/optic-disc/)

## Who gets it

Proliferative diabetic retinopathy is the most frequent cause in adults; trauma predominates in young people and children.

## Causes

- Proliferative diabetic retinopathy
- Retinal tear with posterior vitreous detachment
- Retinal vein occlusion with new vessels
- Trauma
- Neovascular macular degeneration
- Subarachnoid haemorrhage (Terson syndrome)
- Abusive head trauma in infants

## Risk factors

- Diabetes with proliferative retinopathy
- Sickle cell disease
- High myopia
- Trauma

## Pathophysiology

Fragile new vessels growing on the retina bleed when the vitreous pulls on them, or a normal vessel tears when the vitreous detaches. The blood fills the gel and blocks light; it clears slowly over weeks to months.

## Symptoms and signs

- Sudden shower of dark floaters or cobwebs
- Hazy or reddish vision
- Sudden painless loss of vision in severe cases

## Red flags

- Associated curtain or shadow (detachment)
- Trauma with possible open globe
- Infant with vitreous haemorrhage (possible abusive head trauma)
- Pain and redness (neovascular glaucoma)

## Diagnosis

**Clinical**
Reduced red reflex and poor view of the fundus; dilated examination of the other eye often shows the cause (for example diabetic retinopathy).

**Tests**
Glucose or HbA1c, blood pressure, blood count and clotting tests according to the cause.

**Imaging**
Ocular ultrasound when the fundus cannot be seen, to rule out retinal detachment and tumours.

## Differential diagnosis

- Posterior vitreous detachment without bleeding
- Retinal detachment
- Vitritis (inflammation)
- Dense cataract

## Goal of treatment

Find and treat the cause, exclude retinal detachment, and clear the blood if it does not resolve.

## Treatment

**Conservative**
Rest with the head raised so the blood settles, and regular ultrasound until the [retina](https://durgical.com/en/anatomy/retina/) can be seen.

**Procedure**
Laser to the retina or anti-VEGF injections for proliferative diabetic retinopathy.

**Surgical**
Vitrectomy for blood that does not clear, for retinal detachment or for some diabetic cases.

**Medical**
Control of glucose, blood pressure and lipids; antithrombotic drugs are reviewed with the treating doctor, not stopped by the patient.

## Complications

- Tractional or rhegmatogenous retinal detachment
- Neovascular glaucoma
- Ghost-cell glaucoma

## Prognosis

Depends on the cause; many haemorrhages clear and vision recovers when the cause is treated.

## Prevention

- Diabetic retinal screening and timely laser
- Eye protection

## Test yourself

Think of the answer, then tap the question to see it.

## What is the most common cause of vitreous haemorrhage in adults?

Proliferative diabetic retinopathy.

## Which imaging is used when the fundus cannot be seen?

Ocular ultrasound, to rule out retinal detachment.

## What does vitreous haemorrhage with subarachnoid haemorrhage suggest?

Terson syndrome.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/conditions/vitreous-haemorrhage/)

## Why it happens

- [Retinal detachment](https://durgical.com/en/general-pathology/retinal-detachment/)

## Connections

## Related conditions 5

- [Diabetic retinopathy](https://durgical.com/en/conditions/diabetic-retinopathy/)
- [Retinal detachment](https://durgical.com/en/conditions/retinal-detachment/)
- [Central retinal vein occlusion](https://durgical.com/en/conditions/central-retinal-vein-occlusion/)
- [Age-related macular degeneration](https://durgical.com/en/conditions/age-related-macular-degeneration/)
- [Ocular trauma: hyphema and open globe injury](https://durgical.com/en/conditions/ocular-trauma-hyphema-and-open-globe-injury/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Vitreous Hemorrhage](https://www.ncbi.nlm.nih.gov/books/NBK559131/) (StatPearls Publishing (NCBI Bookshelf), 2023).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/conditions/vitreous-haemorrhage/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/vitreous-haemorrhage/