ABSTRACT
Vitreous haemorrhage (VH) complicates disorders of the retina and will often cause severe reduction of vision. The blood in the vitreous gel initially forms a localised clot, but subsequent fibrinolysis causes the dispersion of the haemorrhage throughout the gel. During haemolysis, biconcave erythrocytes lose most of their enclosed haemoglobin and change to spheroidal erythroclasts. The degradation of the released haemoglobin produces pigments, which often stain the gel with an ochre-yellow or orange colour. Cells in the trabecular meshwork can reduce aqueous drainage causing raised intraocular pressure (IOP) and 'erythroclastic glaucoma'. The priority with vitreous haemorrhage is determining the aetiology because some causes require immediate intervention. Scleral indentation may be required to exclude retinal tears. If a view is not available, ultrasound is the mainstay of investigation. Referral for ultrasound will help determine the diagnosis but will usually require specialised input to interpret.
