Each installment in the five-part “Now What?” series will cover a different chronic condition: Submacular hemorrhage needs a special mention as it is directly responsible for the quality of vision.Ĭopyright © 2023, StatPearls Publishing LLC.To help optometrists strengthen their protocols for managing conditions that require ongoing-perhaps life-long-care, this series explains the steps to take after confirming a diagnosis, from day one through long-term management. The most common location is at the superotemporal or inferotemporal margin. Linear hemorrhages which are perpendicular to the optic disc Subretinal hemorrhage- It is located between the RPE(retinal pigment epithelium) and the photoreceptor layer.ĭisc hemorrhage (also known as Drance hemorrhage) Sub-RPE hemorrhage is located between the retinal pigment epithelium and Bruch membrane. Subhyaloid hemorrhages are located between the internal limiting membrane and the posterior hyaloid membrane. Retina hemorrhages can occur at the following locations:įlame-shaped hemorrhages are located in the nerve fiber layer.ĭot and blot hemorrhages are located in the Outer plexiform layer - Inner nuclear layer (OPL-INL)complex. Retinal hemorrhages are important markers signifying local or systemic vascular abnormality, which needs to be thoroughly investigated. Postoperative - also known as delayed suprachoroidal hemorrhage. Intraoperative - also known as expulsive suprachoroidal hemorrhage. It usually occurs intraoperatively and postoperatively, after trauma, and very rarely spontaneously. Suprachoroidal hemorrhage occurs due to the rupture of long or short ciliary arteries into the suprachoroidal space between the choroid and sclera.
If there is hemorrhage inside the Berger space, Cloquet canal, or canal of petit, it is also known as vitreous hemorrhage. Sub ILM hemorrhage is most commonly seen with Valsalva retinopathy, Terson syndrome, and Retinal microaneurysm. It also has a boat-shaped configuration, with the upper border being horizontal. Sub-ILM hemorrhage is bleeding between the internal limiting membrane and the nerve fiber layer of the retina is known as sub-ILM hemorrhage. It is most commonly seen in patients with proliferative diabetic retinopathy.
If the posterior hyaloid is detached, subhyaloid hemorrhage shifts with the eye movement. Subhyaloid hemorrhage is located between the internal limiting membrane and posterior subhyaloid membrane.īoat-shaped configuration: If the posterior hyaloid is intact, subhyaloid hemorrhage is immobile. Preretinal hemorrhage can be subdivided into 2 categories: It can be further subclassified as:Įxtravasation of blood into space lined anteriorly by an anterior hyaloid membrane, laterally by non-pigmented ciliary epithelium, and posteriorly by the posterior hyaloid membrane is known as intragel hemorrhage.Īs the RBC degenerates, the color of the vitreous hemorrhage changes from bright red to yellow. Microhyphema- a very minimal amount of blood in the anterior chamber, which is detectable only on microscopic examination.īleeding in and around the anterior chamber of the eye is known as vitreous hemorrhage. Intraocular hemorrhage can be subdivided depending on the location of the bleed:īleeding from the iris, ciliary body, trabecular meshwork, and associated vasculature into the anterior chamber (bordered by cornea anteriorly, iridocorneal angles laterally, and lens posteriorly) is known as hyphema. It could occur either because of trauma or in association with systemic illness, or very rarely, it could occur spontaneously. It can bleed inside the anterior chamber, vitreous cavity, retina, choroid, suprachoroidal space, or optic disc. Bleeding can occur from any of the structures of the eye where there is a presence of vasculature. Intraocular hemorrhage means bleeding inside the eye.
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