What's the Diagnosis? By Dr. Erica Schramm

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