A dark shadow, curtain, or veil affecting part of your vision is a warning sign that should never be ignored. It can be caused by a retinal detachment or vitreous haemorrhage.
What is a vitreous haemorrhage?
The middle of your eye is normally filled with a clear, jelly-like substance called vitreous gel. A vitreous haemorrhage happens when blood leaks into this gel, causing blurred or cloudy vision.
What causes it?
Bleeding can come from two main sources:
As we age, the vitreous gel can shrink and pull away from the retina (the light-sensitive layer at the back of the eye). This is called a posterior vitreous detachment, and it’s more common in people who are short-sighted. Sometimes, as the gel pulls away, it can tear a blood vessel—or even the retina itself. This is important, because a retinal tear can lead to a retinal detachment if not treated.
Direct injury to the eye can also cause bleeding, though the eye is surprisingly tough and even a hard knock doesn’t always cause a haemorrhage.
Some eye conditions cause fragile, abnormal blood vessels to grow on the retina. These vessels are weak and prone to bleeding. The most common conditions include:
Most retinal tears are small and can be treated using laser or cryotherapy (freezing procedure). This seals the tear and reduces the risk of a retinal detachment.
This is a condition where the retina peels away from the wall of the eye. In most cases the retina detaches because a hole or a tear has formed in the retina allowing fluid to pass underneath the retina.
Treatment involves surgery whose main aim is to seal holes in the retina and reattach the retina. The two methods used in retinal detachment surgery are vitrectomy or scleral buckle or a combination of the two.
This procedure involves removing the vitreous gel (that has caused the retinal tear) from inside the eye. Then to seal the tear the surgeon uses either laser or a freezing probe to make a scar around the tear. A gas or silicone oil bubble is then inserted into the eye to support the retina while it heals. A gas bubble slowly absorbs over 2 to 8 weeks but a silicone oil bubble will need a small operation to remove it at a later date. Your vision will be very blurred initially due to the presence of the gas or oil bubble.
The retinal holes can also be sealed and supported by stitching a piece of silicone rubber or sponge to the outside of the eye. This acts as a ‘splint’ and produces a dent within the eye and pushes the outer wall of the eye up to the hole in the retina. The buckle is not visible on the outside of the eye and usually remains in place permanently.
This procedure involves removing the vitreous gel (that has caused the retinal tear) from inside the eye. Then to seal the tear the surgeon uses either laser or a freezing probe to make a scar around the tear. A gas or silicone oil bubble is then inserted into the eye to support the retina while it heals. A gas bubble slowly absorbs over 2 to 8 weeks but a silicone oil bubble will need a small operation to remove it at a later date. Your vision will be very blurred initially due to the presence of the gas or oil bubble.
If you have been given any posturing instructions then these should be followed. You can bath or shower, but avoid splashing water near the eye. Generally you may do anything with which you are comfortable. Most people choose not to drive over the first few weeks. You must not fly until the gas bubble has gone and you must inform the anaesthetist if you require a general anaesthetic for any operation while there is gas in your eye.
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