Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
!
Blood can conceal a retinal tear
A sudden vitreous haemorrhage can obscure the retinal lesion that caused it, including an urgent tear or detachment.
Action: Arrange emergency same-day ophthalmic assessment for new suspected vitreous haemorrhage, especially with flashes, a field shadow or reduced vision. An obscured view or an initially negative ultrasound does not establish a benign cause. Protect the eye and avoid pressure if trauma raises concern for globe rupture.
Synopsis
Identify bleeding into the vitreous, investigate its retinal source despite an obscured fundal view, and distinguish urgent structural disease from selected specialist-supervised observation or surgery.
Vitreous haemorrhage describes blood within the vitreous cavity and is a finding requiring a cause.
Proliferative diabetic retinopathy, retinal tears, trauma and other retinal vascular disease are important possibilities.
Patients may describe black dots, cobwebs, smoke, red haze or sudden painless reduction in vision.
Key red flags
Sudden dense floaters, haze or visual loss with suspected vitreous blood needs emergency eye assessment to identify a retinal source.
Investigation priorities
01
Visual acuity and ocular historyFirst step
Measure functional loss and identify clues to the bleeding source.
Management branches
Acute presentationFind the source behind the haemorrhage
A new episode of visual haze or loss is suspected to represent vitreous blood.
Arrange emergency ophthalmic assessment and communicate accompanying flashes, field change, trauma and the degree of visual loss.
Support examination of retinal attachment with suitable imaging when blood obscures the view, avoiding pressure if an open globe is possible.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.