Hemophthalmus is the entry of blood into a glassy 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 vessels of the retina, which are more fragile compared to the others.
Causes
The causes of hemophthalmus of the eye can be as follows:
- Insulin deficiency, due to which the posterior 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 of doctors during the operation, hemophthalmus may develop due to improper care or even a simple reaction of the body.
- High blood cholesterol. Why cholesterol becomes the cause of this pathology is not known, but their relationship has already been proven.
- Excessive intraocular pressure.
- Blockage of blood vessels and lack of blood flow to the eyes.
- Vascular inflammation. For example, due to infection, vasculitis, hypothermia or overheating, contact with poisons, chemicals or other dangerous substances. Sometimes the vessels can become inflamed, thus reacting to the vaccine.
- Retinal damage during illness or its detachment.
- Abnormal development of blood vessels or any other congenital malformation of blood vessels in the eyes.
- Banal injuries that can be obtained while playing sports, in a fight, at home, in an accident or on the street.
Symptoms
The following symptoms may cause suspected hemophthalmos of the eye:
- Wandering shadows appear.
- A sharp deterioration in visibility, everything appears in a light fog. Most often, in the morning, visibility is restored, and in the evening it falls again. It is possible to drop vision to a level where only light and shadow are distinguished by the eye.
- Redness of the protein of the eye. The protein turns red or scarlet partially or completely.
- The appearance of painful sensations in the presence of a large amount of light: sunny on the street or artificial indoors.
- Items may appear cloudy and fuzzy.
- Visual perception is prevented by flies, stripes, cobwebs, threads, dots or small spots. Such interference is usually colored in shades of red or black.
- With complications, lightning, flashes, sparks, and similar lights can be added to interference.
Symptoms that occur less frequently:
- Dry feeling in the eye.
- Unpleasant sensations in the area of the damaged eye, for example, a tingling sensation or a feeling of interfering mote.
- In a particularly severe case, the eyes cease to respond to light, complete loss of vision occurs.
- The above symptoms may be accompanied by headache and general weakness in the body.
Kinds
Depending on how severely the vitreous is affected, the following types of hemophthalmus are distinguished. Each of them has its own symptoms and differs in the method of therapy.
Full
With this type of pathology, the vitreous is 75 percent filled with blood. This type of hemophthalmus is most often caused by a variety of eyeball injuries. This disease is associated with an unconditional loss of objective vision. The patient has the ability to distinguish only light and black, but to navigate in space, to distinguish objects, he does not have the ability (including those things that are close).
Subtotal
Hemorrhage takes at least 35 percent and not more than 75% of the size of the gel-like substance. As a rule, proliferative diabetic retinopathy is a prerequisite for subtotal hemophthalmus. She, 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 sees black spots in front of the eyes that cross out a huge fraction of the visual field. A person has the ability to distinguish the boundaries of objects, the appearance of another person, but objective vision is significantly reduced.
Selective hemophthalmus of the eye
Diseases inherent in the filling of the vitreous body with blood are 35 percent or less. This is a common phenomenon, the complex of reasons for which often combines arterial hypertension, diabetes mellitus, detachment, and retinal rupture.
Selective hemophthalmus is a more common form of the presented disease, which is characterized by a relatively mild course. Such a diagnosis is literally always characterized by a positive prognosis for cure, restoration of the ability to see.
In the case of selective hemophthalmus, there are dark dots in front of the eyes or stripes of a dark or reddish hue. The patient's vision may be blurred, a haze similar to a veil appears before the eyes.
Each of the varieties of the disease most often appears in only one of two eyes. The simultaneous occurrence in both eyes is a rarity. There is only one exception to this rule - Terson's syndrome, due to which, as a rule, bilateral hemorrhage appears.
Types
When the vessels of the eye rupture, blood enters the vitreous body. Hemophthalmus is of three types:
- partial - less than three vitreous bodies are filled in the blood;
- subtotal - from three to four;
- total hemophthalmus of the eye.
Surveys
The condition of the retina and eyeball is checked by examination. For this, the chromatic function of the retina is performed. After the first examination, the doctor prescribes treatment.
Diagnosis of retinal diseases
With pathologies associated with the retina, a specialist needs to:
- determine visual acuity;
- conduct a study of 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, treatment of partial hemophthalmus of the eye, as well as full, can be carried out by several methods: medication, enzyme therapy and surgical. Treatment is selected by an ophthalmologist depending on the area and depth of eye damage.
Drug treatment
Drug treatment is effective only if it is started within the first 5-7 hours after the manifestation of hemorrhage. Drug therapy for hemophthalmia of the eye is divided into two stages. Each of them is quite important and requires careful observance of all recommendations and rules for the use of medicines.
The first stage is aimed at stopping hemorrhage and stabilizing 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.
- Parmidin has properties similar to those characteristic of Doxium. It differs in the active substance, in the role of which sodium etamisylate acts.
- "Pentinyl" - a drug that has an expanding effect on the vessels of the microvasculature of the eye, which affects the elasticity of red blood cell 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 retinal vessels and inhibits the action of histamine.
- "Chlorist" is a coagulant of the 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 drugs on your own with a hemorrhage in the eye.
The second stage is drug treatment aimed at resolving the hematoma. At this stage, drugs containing vitamins C and PP are used, as well as:
- "Emoksipin" - a drug containing antioxidants that improve metabolism. It is prescribed as intramuscular injection 1 time per day for 14 days.
- Mexidol. The medicine has a pronounced membrane stabilizing effect. Assigned to 100 ml per day for 10 days.
- "Histochrome". The drug is used to relieve eye swelling and reduce hematoma. Treatment is adjusted depending on the response of the body to the use of "Histochrome". If necessary, the attending physician can add eye drops containing lidase and potassium iodine to the main course of medications. Important: if the treatment is delayed, drug therapy will be ineffective and the blood clot resulting from hemorrhage will have to be removed surgically.
Enzyme therapy
An important part in the complex treatment of hemophthalmus of the eye (right or left) is enzyme therapy. It is aimed at resorption of a blood clot. The main method of treatment is the use of enzymes that contribute to:
- cleansing inflammation from harmful bacteria and necrotic formations;
- improving the outflow of blood from the vitreous body;
- decrease in clotting of a blood clot;
- acceleration of resorption of a blood clot coagulated.
The main drugs that are 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.
- Protelizin is an enzyme used in ophthalmic practice to break down necrotic tissues and lyse blood clots. At present, enzyme therapy is a more sparing alternative to drug and surgical treatment of eye hemophthalmus.
Surgery
In cases where drug treatment and enzymatic therapy do not bring results or the patient seeks help more than 48 hours after the start of the hemorrhage, surgical removal of the hematoma is prescribed. Surgery 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 surgery is as follows:
- the eyeball is fixed in one position;
- from two opposite sides of the hematoma (depending on its position) two punctures are made;
- an LED with a camera is inserted into one puncture, an aspiration needle into the second;
- the needle is used to puncture the vitreous body;
- after the puncture, the needle is removed, and a vacuum pump is put in its place, with which it is removed in parts of the hematoma, as well as pathological tissues;
- a solution of salts is introduced into the space formed.
Complications in the postoperative period include the possibility of repeated hemorrhage. This complication is possible in cases where the patient does not comply with medical recommendations, does not adhere to the established regimen, and does not take prescribed medications.
Visual impairment may occur. A complication occurs when the lens of the eye was damaged during surgery. Even with microdamage, visual acuity can fall by 2-3 diopters. And remember, timely access to a doctor will save you from unnecessary consequences.