What's the Diagnosis? By Dr. Erica Schramm
Wed, 10/25/2017 - 7:00am
A 52 yo F with a past medical history of DM presents to the ED with two days of “seeing floaters.” She denies eye pain, vision change/loss, or trauma. A bedside ocular ultrasound is obtained. What's the diagnosis? (scroll down for answer)
Answer: Vitreous Hemorrhage
- Defined as the extravasation of blood into one of the potential spaces formed within and around the vitreous body
- Patients often present with complaint of visual haziness, perception of shadows, or floaters
- Opthalmoscope exam shows blood within the vitreous gel
- Appears on bedside US as a swirling cloud like opacity that moves with eye movements and does not appear tethered to the optic disc or retina
- Most common cause is diabetic retinopathy, which results in neovascularization of retinal vessels
- Trauma is the leading cause in younger population
- When vitreous hemorrhage is present on US, it is important to rule out concomitant retinal detachment, as this is an indication for surgical intervention