Underlying eye disease often provides clues to the cause of hemorrhage. Patients with acute vitreous hemorrhage frequently seek emergency care because the loss of vision is dramatic. Visual acuity varies with the degree of hemorrhage. The patient recognizes minimal bleeding as new multiple floaters. Moderate hemorrhage may be described graphically as 1 or more dark streaks that subsequently break up into numerous, minute black spots.
Dense hemorrhage can reduce vision to the light perception level.
Patients may report visual obstruction changes with eye or head movement and that they tend to try to look around the obstruction. In the absence of trauma, no pain is experienced with vitreous hemorrhage. Examining the uninvolved eye may provide clues to the underlying cause of hemorrhage in the involved eye, such as dot and blot hemorrhages of diabetic retinopathy, drusen and exudate in macular degeneration, or venous dilation in hypertensive disease and vein occlusion. Once diagnosis of vitreous hemorrhage is confirmed, ophthalmologic consultation is indicated to determine the causes and appropriate intervention. Test pupil response.