Hemophthalmos is the ingress of blood into the vitreous body. The reason for this may be a violation of the structure of the retinal vessels during its rupture or a violation of the integrity of the walls of the newly formed retinal vessels, which are more fragile than the others.
Reasons
The causes of eye hemophthalmos may be as follows:
- Insulin deficiency, due to which the back segment of the retina does not receive enough blood.
- Sudden jumps in blood pressure.
- Intraocular malignant or benign tumor.
- Surgical intervention. During the rehabilitation period, due to a mistake by doctors during the operation, due to improper care or even a simple reaction of the body, hemophthalmus may develop.
- High blood cholesterol. Why cholesterol causes this pathology is unknown, but their relationship has already been proven.
- Exceeding the norm of intraocular pressure.
- Clogging of blood vessels and lack of blood flow to the eyes.
- Inflammation of blood vessels. For example, due to infection, vasculitis, hypothermia or overheating, contact with poisons, chemicals or other dangerous substances. Sometimes the vessels can become inflamed, reacting in this way to the vaccine.
- Damage of the retina during the disease or its detachment.
- Abnormal vascular development or any other congenital vascular disorder in the eyes.
- Tranquil injuries that can be sustained while playing sports, in a fight, at home, in an accident or on the street.
Symptoms
Suspicion of hemophthalmos eyes can cause the following symptoms:
- Wandering shadows appear.
- Sharp deterioration in visibility, everything appears in a light fog. Most often, visibility is restored in the morning, and falls again in the evening. Vision may fall to a level where only light and shadow can be distinguished by the eye.
- Redness of the white of the eye. The protein turns red or scarlet in part or in full.
- The appearance of pain in the presence of a large amount of light: sunny outdoors or artificial indoors.
- Items may appear hazy and fuzzy.
- Flies, stripes, cobwebs, threads, dots or small spots interfere with visual perception. Such interference is usually colored in shades of red or black.
- When complicated, lightning, flashes, sparks and similar lights can be added to interference.
Fewer symptoms:
- Feelingdryness in the eye.
- Unpleasant sensations in the area of the injured eye, such as tingling or the sensation of a disturbing speck.
- In a particularly severe case, the eyes stop responding to light, complete loss of vision occurs.
- The above symptoms may be accompanied by headache and general weakness in the body.
Views
Depending on how severely the vitreous body is affected, the following types of hemophthalmia are distinguished. Each of them has its own symptoms and differs in the method of therapy.
Full
With this type of pathology, the vitreous body is 75 percent filled with blood. This type of hemophthalmos is most often caused by various injuries of the eyeball. This disease is associated with an unconditional loss of objective vision. The patient has the ability to distinguish only light and black, but he is unable to navigate in space, to distinguish between objects (including those things that are close).
Subtotal
Hemorrhage occupies at least 35 percent and no more than 75% of the size of the gel-like substance. As a rule, proliferative diabetic retinopathy acts as a prerequisite for subtotal hemophthalmia. It, in turn, is considered a consequence of diabetes.
Terson's syndrome can lead to the development of this type of pathology. With a subtotal type of disease, the patient notices black spots in front of the eyes that cross out a huge share of the fieldvision. A person has the ability to distinguish the boundaries of objects, the appearance of another person, but objective vision is significantly reduced.
Selective eye hemophthalmos
The disease is characterized by filling the vitreous body with blood by 35 percent or less. This is a frequent phenomenon, the complex of causes of which often combines arterial hypertension, diabetes mellitus, detachment, retinal rupture.
Selective hemophthalmos is a more common variety of the presented disease, which is characterized by a relatively mild course. Such a diagnosis is literally always characterized by a positive prognosis for a cure, restoration of the ability to see.
In the case of selective hemophthalmos, there are dark dots or stripes of a dark or reddish tint before the eyes. The patient's vision may be blurred, a haze appears before the eyes, similar to a veil.
Each of the varieties of the disease most often appears in only one of the two eyes. Simultaneous occurrence in both eyes is a rarity. There is only one exception to this rule - Terson's syndrome, as a result of which, as a rule, bilateral hemorrhage appears.
Types
When the vessels of the eye rupture, blood enters the vitreous body. There are three types of hemophthalmos:
- partial - less than three vitreous bodies are filled in the blood;
- subtotal - from three to four;
- total hemophthalmos of the eye.
Examinations
The state of the retina and the eyeball is checked byexaminations. To do this, carry out the chromatic function of the retina. After the first examination, the doctor prescribes the treatment.
Diagnostics in diseases of the retina
For pathologies associated with the retina, a specialist needs:
- determine visual acuity;
- do research on color thresholds;
- determine the pathology of the retina and the severity of the process.
And also on the examination, the boundary of vision is necessarily determined.
Treatment
Currently, the treatment of partial hemophthalmos of the eye, as well as complete, can be done by several methods: medication, enzyme therapy and surgery. Treatment is selected by the ophthalmologist depending on the area and depth of damage to the eye.
Medicated treatment
Drug treatment is effective only if it is started within the first 5-7 hours after the onset of hemorrhage. Drug therapy for hemophthalmos of the eye is divided into two stages. Each of them is quite important and requires careful adherence to all recommendations and rules for the use of medicines.
The first stage is aimed at stopping the hemorrhage and stabilizing the state of the vitreous body. At this stage, coagulants and drugs are used to maintain the elasticity of the eye wall. These include:
- "Doxium" is a drug that helps to make the eye wall more elastic and permeable. The active substance is calcium dobiselate.
- "Parmidine" has properties similar to those of"Doxium". Differs in the active ingredient, which is sodium etamisylate.
- "Pentynyl" is a drug that has an expanding effect on the vessels of the microcirculation of the eye, which affects the elasticity of erythrocyte membranes and blood properties.
- "Dikvertin" is a drug that increases the level of nitric oxide in the blood, which leads to an increase in the activity of microcirculation processes.
- "Pertinol" relieves spasm from the vessels of the retina and suppresses the action of histamine.
- "Chlorista" is a coagulant with a general spectrum of action.
- Heparin is used to localize and stop bleeding. All of these drugs can be prescribed in the form of drops or intramuscular injections. It is very dangerous to use medications on your own when a hemorrhage in the eye has begun.
The second stage is drug treatment aimed at resorption of the hematoma. At this stage, drugs containing vitamins C and PP are used, as well as:
- "Emoxipin" is a drug containing antioxidants that improve metabolism. It is prescribed as an intramuscular injection once a day for 14 days.
- "Mexidol". The drug has a pronounced membrane-stabilizing effect. Assigned to 100 ml per day for 10 days.
- "Histochrome". The drug is used to relieve swelling of the eye and reduce hematoma. Treatment is adjusted depending on the body's response to the use of "Histochrome". To the main course of medicalmedications, the attending physician, if necessary, can add eye drops containing lidase and potassium iodine. Important: if you delay the start of treatment, drug therapy will be ineffective and the blood clot formed as a result of hemorrhage will have to be removed surgically.
Enzyme Therapy
An important part in the complex treatment of eye hemophthalmia (right or left) is enzyme therapy. It is aimed at resorption of the blood clot. The main of this treatment method is the use of enzymes that promote:
- cleansing inflammation from harmful bacteria and necrotic formations;
- improve the outflow of blood from the vitreous body;
- reduce blood clot clotting;
- acceleration of resorption of coagulated blood.
The main drugs used in enzyme therapy are:
- "Unitol". The drug is used as an injection under the conjunctiva or intravenously. It has a resolving and regenerating effect.
- Protelysin is an enzyme used in ophthalmic practice to break down necrotic tissues and lyse blood clots. Currently, enzyme therapy is a more gentle alternative to medical and surgical treatment of eye hemophthalmia.
Surgical treatment
In cases where drug treatment and enzyme therapy fail or the patient seeks help after more than 48 hoursafter the onset of hemorrhage, surgical removal of the hematoma is prescribed. The operation for hemophthalmia of the eye (left or right) occurs under local or general anesthesia, depending on the characteristics of the patient's condition and the spread of the pathological process in the eye. The essence of the surgical intervention is as follows:
- eyeball fixed in one position;
- two punctures are made from two opposite sides of the hematoma (depending on its position);
- an LED with a camera is inserted into one puncture, an aspiration needle into the second;
- the vitreous body is punctured with a needle;
- after the puncture, the needle is removed and a vacuum pump is put in its place, with the help of which the hematoma is removed in parts, as well as pathological tissues;
- a solution of s alts is introduced into the formed space.
Complications in the postoperative period include the possibility of re-hemorrhage. This complication is possible in cases where the patient does not follow medical recommendations, does not adhere to the established regimen, does not take prescribed medications.
Visual acuity may be impaired. A complication occurs when the lens of the eye was damaged during the operation. Even with microdamage, visual acuity can drop by 2-3 diopters. And remember, a timely visit to the doctor will save you from unnecessary consequences.
