Submacular Hemorrhage (SMH)


What is Submacular haemorrhage?

Submacular hemorrhage (SMH) is a term which describes a condition characterized by the presence of blood in the potential space between the retinal pigment epithelium and the retinal layer. The blood comes from fragile new vessels in the choroidal layer, formed in the process of choroidal neovascularization CNV).

Can stress cause retinal hemorrhage?

As we know, stress often has a negative impact on a person’s physical well-being and can even be hard on the eyes. If you frequently experience stress you might wonder, can stress cause retinal detachment? The simple answer is no, stress cannot cause retinal detachment.

How long does eye trauma heal?

A minor scratch should heal on its own in 1 to 3 days. More severe abrasions may take longer. While your eye heals: Don’t rub your eye.

Submacular Hemorrhage (SMH)

Submacular hemorrhage (SMH) is a term which describes a condition characterized by the presence of blood in the potential space between the retinal pigment epithelium and the retinal layer. The blood comes from fragile new vessels in the choroidal layer, formed in the process of choroidal neovascularization CNV).Feb 27, 2019

What is subretinal fibrosis?

Subretinal fibrosis is defined as the development of either band-like or plaque-like areas of fibrosis underneath the retina due to choroidal neovascularization (CNV) or proliferation of retinal pigment epithelial (RPE) cells and Mller cells.

Can high blood pressure cause retinal hemorrhage?

Damage to the retina from high blood pressure is called hypertensive retinopathy. It occurs as the existing high blood pressure causes changes to the microvasculature of the retina. Some of the first findings in the disease are flame hemorrhages and cotton wool spots.

Is an eye hemorrhage serious?

A subconjunctival hemorrhage often occurs without any obvious harm to your eye. Even a strong sneeze or cough can cause a blood vessel to break in the eye. You don’t need to treat it. A subconjunctival hemorrhage may look alarming, but it’s usually a harmless condition that disappears within two weeks or so.

How do you treat commotio retina?

There is no treatment for commotio retinae. However, most people fully recover in 3 to 4 weeks. In cases where trauma causes more severe damage, you may recover only part of your eyesight.

How long does it take for a macular hemorrhage to heal?

In many cases, they resolve spontaneously in 2-3 months, although if the bleeding is not reabsorbed, it may require a surgery called vitrectomy.

What is white without pressure?

White without pressure (WWP) describes a finding that your retina doctor may see when examining the peripheral retina. WWP is found in 15-30 percent of the population and is characterized by a discrete whitish-gray area in the far peripheral retina that is bordered by a dark line.

Can crying cause a detached retina?

Tears can form in the retina, creating a risk of retinal detachment and severe loss of vision.

Why is vitrectomy performed?

Vitrectomy procedures are often done to allow surgeons access to the back of the eye, during operations for retinal conditions. It is also commonly done to drain vitreous fluid that has become cloudy or bloody, or filled with floaters or clumps of tissue.

What causes Submacular hemorrhage?

Submacular hemorrhage frequently results from a choroidal neovascular membrane secondary to age-related macular degeneration. Other conditions associated with CNVM, including myopia, trauma, ocular histoplasmosis and angioid streaks, can also lead to submacular hemorrhage.

Is vitreous hemorrhage an emergency?

In many cases, a vitreous hemorrhage can develop very quickly and without pain that indicates a medical emergency. An ophthalmologist or nearby emergency room should be contacted promptly if symptoms of vitreous hemorrhages, such as sudden floaters or cobwebs in vision or a red or shadowy effect, occur.

What causes Valsalva retinopathy?

Valsalva retinopathy is a preretinal hemorrhage caused by a sudden increase in intrathoracic or intraabdominal pressure. It was first described by Duane in 1972. It usually occurs in an otherwise healthy eye and spontaneously resolves.

What is angle recession glaucoma?

Angle recession glaucoma (ARG) is a secondary open angle glaucoma that is associated with ocular trauma. Recession of the anterior chamber angle is a common slit lamp and gonioscopic finding following concussive ocular trauma.

Do retinal hemorrhages go away?

Retinal hemorrhages, especially mild ones not associated with chronic disease, will normally reabsorb without treatment. Laser surgery is a treatment option which uses a laser beam to seal off damaged blood vessels in the retina.

How is subretinal hemorrhage treated?

PPV combined with submacular injection of 10-20 g of TPA in 0.05 mL of balanced salt solution (BSS) plus 1.25 mg bevacizumab in 0.05 mL BSS followed by air-fluid gas exchange using 20% SF6 gas has also been shown to be beneficial in treating subretinal hemorrhages in AMD patients.

Can high blood pressure cause burst blood vessels in the eye?

Some health conditions can also be responsible for a burst blood vessel in the eye. Hypertension, or high blood pressure, can cause this to happen even if a person is taking medication to manage the condition. Other vascular disorders, such as diabetes and hyperlipidemia, can also increase the risk.

Do Roth spots go away?

There’s no specific treatment for Roth spots, since a variety of conditions can cause them. However, once the underlying condition is treated, Roth spots usually go away on their own.

What is the function of the macula in the human eye?

The macula, macula lutea, is the small, yellowish central portion of the retina of the human eye. The macula is the most active part of the eye and processes the light signals that allow us to do fine work. It is responsible for sharp, clear central vision and the ability to perceive color.

What is Submacular surgery?

Submacular surgical techniques can be used to access the subretinal space to remove many types of CNV: subfoveal, juxtafoveal, extrafoveal, peripapillary, occult, and hemorrhagic. They can also be used to address other subretinal pathology such as fibrosis, parasites, and intraocular foreign bodies.

Is vitreous hemorrhage painful?

Vitreous Haemorrhage symptoms Vitreous haemorrhage normally occurs suddenly and without any pain. Symptoms range from the sudden appearance of spots or floaters in your vision to a sudden blurring of vision, and in severe cases, sudden blindness.

Is vitreous hemorrhage serious?

Having blood in the vitreous gel can keep light from reaching your retina. This causes vision problems. If the bleeding is severe, it can cause vision loss.

How do you treat a Submacular hemorrhage?


  1. Antivascular endothelial growth factor (anti-VEGF) monotherapy.
  2. Pneumatic displacement (PD) + anti-VEGF therapy.
  3. Intravitreal recombinant tissue plasminogen activator (rtPA) + anti-VEGF + PD.
  4. Pars plana vitrectomy + subretinal injection of rtPA + subretinal or intravitreal PD.

Can straining to poop cause eye floaters?

Causes of Floaters Floaters are often a result of the normal aging process, but can also occur after any sudden head movement, such as sneezing, coughing, or falling down; or from straining during childbirth, lifting something heavy, or constipation.

How long do retinal hemorrhages last?

Retinal Nerve Fiber Layer (RNFL) Hemorrhages Flame shaped hemorrhages: These hemorrhages are diffuse, found in the posterior pole, and last approximately 6 to 12 weeks.

What diseases affect the retina?

Common retinal diseases and conditions include:

  • Retinal tear. …
  • Retinal detachment. …
  • Diabetic retinopathy. …
  • Epiretinal membrane. …
  • Macular hole. …
  • Macular degeneration. …
  • Retinitis pigmentosa.

What is subretinal haemorrhage?

Definition. Subretinal hemorrhage is an accumulation of blood between the neurosensory retina and the Retinal Pigment Epithelium (RPE) arising from the choroidal or retinal circulation.

What causes subretinal hemorrhage?

Subretinal hemorrhage can arise from the retinal and/or choroidal circulation. Significant subretinal hemorrhage occurs in several conditions, but most commonly is associated with age-related macular degeneration, presumed ocular histoplasmosis, high myopia, retinal arterial macroaneurysm, and trauma.

What is the success rate of a vitrectomy?

The success rate for vitrectomy is around 90 percent, even if you’re over 60.

Can bleeding behind the eye cause blindness?

A vitreous haemorrhage can be severe and result in legal blindness, or it may be mild and result only in annoying black floaters. The severity of visual loss is related to the density of the haemorrhage and the underlying cause for the bleeding.

Is vitrectomy laser surgery?

Vitrectomy is a surgical procedure undertaken by a specialist where the vitreous humor gel that fills the eye cavity is removed to provide better access to the retina. This allows for a variety of repairs, including the removal of scar tissue, laser repair of retinal detachments and treatment of macular holes.

Can retina damage be repaired?

Yes, in many cases an eye doctor can repair a damaged retina. While a patient may not experience completely restored vision, retinal repair can prevent further vision loss and stabilize vision. It’s important that patients get treatment for their damaged retinas as soon as possible.

What are retinas?

The retina is a layer of tissue in the back of your eye that senses light and sends images to your brain. In the center of this nerve tissue is the macula. It provides the sharp, central vision needed for reading, driving and seeing fine detail. Retinal disorders affect this vital tissue.

What are symptoms of retina problems?

Retinal disorders can share a number of similar symptoms, which may include:

  • seeing flashes of light.
  • the sudden appearance of floaters.
  • changes in vision.
  • blurry vision or a loss of vision in some areas of the visual field.
  • reduced central or side (peripheral) vision.
  • a sudden loss of vision.
  • changes in color perception.

Is macular hemorrhage serious?

When retinal hemorrhages occur, symptoms range from the undetectable to severe vision problems. Vision problems are often temporary, but in some instances, they can be permanent. If you are experiencing vision problems of any kind, it is important that you seek treatment from professional, experienced eye doctors.

Can a vitrectomy be done twice?

Conclusions: If repeat vitrectomy with membrane peeling is performed too early, there may not be adequate time for Mller cells to re-form a layer of endplates over the denuded retinal nerve fiber layer, exposing it to damage during the second operation with resultant poor vision.

What causes sub retinal fluid?

Subretinal fluid (SRF) from the choroid enters the subretinal space through damaged pigment epithelium caused by inflammation or tumour. In the ‘uveal effusion syndrome’ shifting subretinal fluid is the typical feature.

How long does it take to recover from vitreous hemorrhage?

Recovery from the procedure will take up to 6 weeks and complete vision recovery will take a little longer.

What is the difference between vitreous hemorrhage and retinal hemorrhage?

Decrease the gain to help differentiate between the two. Vitreous hemorrhage is usually less dense and will fade as the gain is decreased. It usually layers inferiorly with gravity. Ocular movements produce a rapid, staccato motion of the hemorrhage, unlike a retinal detachment that is stiffer and slower in movements.

What is a macular hemorrhage?

Caused by alterations to retinal or choroidal circulation, macular hemorrhage is an accumulation of blood in the macular area. Subretinal hemorrhages have a worse prognosis, due to the toxicity of the blood on the photoreceptors and the retinal cells.