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Sub-Hyaloid Hemorrhage!


-Accumulation of blood in the subhyaloid or retrohyaloid space i.e. between the ILM and posterior hyaloid causing a localised detachment of the vitreous from the retina.

-The hemorrhage is sharply demarcated because the hyaloid is attached in the region surrounding the hemorrhage.

-It begins as a circular shape and later becomes crescentic with a straight upper margin due to the effect of gravity giving it a boat shape.

-Source of blood: Retinal blood vessel capillaries.

-Severe vision loss if it occurs in the macular area.


Causes:

1. Proliferative Diabetic Retinopathy

2. Blunt trauma

3. BRVO

4. Anemic/ Leukemic retinopathy

5. PCV

6. Valsalva retinopathy

7. Retinal microaneurysm rupture

8. Terson syndrome

9. Wet ARMD


Complications:


1. ERM formation with VMT

2. Retinal detachment

3. Amblyopia

4. Toxic effects of the long standing hemorrhage due to extended contact with hemoglobin and Iron- photoreceptor toxicity


Management:


-Observation.

-Nd yag hyaloidotomy.

-Pneumatic retinopexy with or without tissue plasminogen activator.

-Pars plana vitrectomy.


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