Retinal hemorrhage is a disorder of the eye in which bleeding occurs in the retina, the light sensitive tissue, located on the back wall of the eye.[1] There are photoreceptor cells in the retina called rods and cones, which transduce light energy into nerve signals that can be processed by the brain to form visual images.[2] Retinal hemorrhage can affect adults, and newborn babies and infants may also suffer from this disorder.
A retinal hemorrhage can be caused by several medical conditions such as hypertension, retinal vein occlusion (a blockage of a retinal vein), anemia, leukemia or diabetes.
Signs and symptoms
At the early stage, a retinal hemorrhage may not show any symptom at all.
Some symptoms may include:
- Seeing floaters in the vision
- Seeing cobwebs in the vision
- Seeing haze or shadows
- Distorted vision
- Rapid flashes of light in peripheral vision
- Red tint to vision
- Blurryness
- Sudden blindness
Other symptoms may include head aches, pain at the temple.
Causes
Retinal hemorrhages commonly occur in high altitude climbers, most likely due to the effects of systemic hypoxia on the eye. Risk is correlated with the maximum altitude reached, duration of exposure to high altitude conditions, and climb rate.[3]
Retinal hemorrhages are believed by some to be associated with abusive head traumas (AHT). According to this theory, the mechanism of the trauma is believed to be repeated acceleration and deceleration with or without blunt impact (shaken baby syndrome).[4] However, in recent years there has been significant inquiry into the scientific foundations for the theory of shaken baby syndrome, with many scientists and legal scholars concluding the theory is not supported by scientific evidence.[5][6]
Surmounting scientific evidence suggests that retinal hemorrhages are in fact not caused by abusive trauma as previously assumed, but may often have accidental or natural causes.[7][8][9]
Diagnosis
A retinal hemorrhage is generally diagnosed by using an ophthalmoscope or fundus camera in order to examine the inside of the eye. A fluorescein angiography test may be conducted, in which a fluorescent dye is often injected into the patient's bloodstream beforehand so the administering ophthalmologist can have a more detailed view and examination on the blood vessels in the retina.[10] The fluorescent dye can have dangerous side effects: see Fluorescein
Eye examination may be done to check the eye(s) conditions, for instance to check how well the patient sees straight ahead, off to the sides and at different distances.
Blood tests may provide information about the patient's overall health and may also reveal the medical condition that may have caused retinal hemorrhage.[1]
Prevention
It is recommended to consult with ophthalmologist or optometrist as early as possible, particularly for people with vision problems, these includes floaters, flashes, cobwebs or spots in their vision. Preventive measures such as regular prenatal care and monitoring of infants with high risks of the disorder may be done to avoid further complications of retinal hemorrhages in infants. For retinal hemorrhages associated with hypertension, blood pressure can be controlled by having regular blood pressure check ups, frequent exercise, monitor daily food intakes and to practice a stress-free lifestyle.[10]
Treatment
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.[11] Anti-vascular endothelial growth factor (VEGF) drugs like Avastin and Lucentis have also been shown to repair retinal hemorrhaging in diabetic patients and patients with hemorrhages associated with new vessel growth.[12][13]
Alternative treatments may include providing necessary nutrients to strengthen and heal damaged blood vessels, through the consumption of dietary supplements such as Vitamins A, B, C and E. Also, the essential fatty acids including omega-3 from fish oil and flaxseed oil.[14]
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