Vitreous Haemorrhage: Symptoms, Causes, and Prognosis

In some cases, a vitreous haemorrhage can be harmless and resolve on its own. But in others, it’s a warning sign of something more serious — especially if it’s caused by:

• A retinal tear or detachment
• Advanced diabetic retinopathy
• Abnormal blood vessels growing in the retina (neovascularisation) secondary to retinal vein occlusion or other cause

These can threaten permanent vision loss if not treated promptly. That’s why any sudden onset of floaters, flashes, or loss of vision should be assessed urgently.

Key symptoms of vitreous haemorrhage:

• A sudden shower of black dots or floaters
• Cloudy or hazy vision
• A red tinge or dark shadow in vision
• Flashes of light
• Difficulty reading or recognising faces

Some people describe it as “looking through a fog”.

At our Birmingham eye clinic, we regularly assess these symptoms using dilated retinal examination and high-resolution OCT scans. If we detect a tear, we’ll urgently refer you to a vitreoretinal surgeon for emergency treatment. If it’s caused by diabetic retinopathy, we can often begin treatment directly in clinic.

The long-term outcome depends on:

• The underlying cause
• The speed of diagnosis and treatment
• The presence of retinal damage

Good prognosis

• If caused by a posterior vitreous detachment (PVD) with no retinal tear, many people make a full recovery without lasting damage.

Cautious prognosis

• If due to diabetic retinopathy, there may be long-term damage or risk of re-bleeding if diabetes is not controlled.

Poorer prognosis

• If a retinal detachment or long-standing PDR is involved, there’s a higher risk of permanent vision loss.

That’s why prompt diagnosis is crucial. At DS Eye Surgeon in Birmingham, we perform dilated funduscopy to quickly identify the cause and start appropriate treatment or referral.

Causes of vitreous haemorrhage (common in private practice)

• Diabetic retinopathy: Abnormal new blood vessels grow and bleed
• Posterior vitreous detachment (PVD): Normal ageing changes that sometimes pull on the retina
• Retinal tear or detachment
• Trauma (e.g. sports injuries or falls)
• Blocked retinal vein (retinal vein occlusion)

As a retinal specialist with expertise in diabetic eye disease, I often see vitreous haemorrhage in patients with poorly controlled or long-standing diabetes. In these cases, early laser and injection therapy can help stabilise vision and prevent further bleeding.

Not always — many cases of vitreous haemorrhage do not require surgery and can be safely monitored, especially if the bleed is mild and the underlying cause is stable. However, in some situations, surgery (called vitrectomy) may be recommended to restore vision or to treat the cause of the bleeding.

When observation is appropriate

In many cases — especially if the bleed is partial and the retina can still be visualised — your eye specialist may recommend watchful waiting. Over time (weeks to months), the blood can naturally settle or be reabsorbed by the body. During this period, we monitor closely to ensure no progression or underlying retinal detachment is missed.

Observation is often chosen when:

• The haemorrhage is mild to moderate

• There is no retinal tear or detachment

• The cause (e.g. diabetic retinopathy) is being treated medically

• You are not in urgent need of visual recovery (e.g. not relying on that eye for driving or work)

When surgery may be needed

A vitrectomy is a surgical procedure where the blood-filled vitreous is removed and replaced with a clear fluid, allowing light to reach the retina again. This may be considered when:

• The haemorrhage is dense or longstanding, and vision has not improved over several weeks

• The retina cannot be visualised, making it impossible to rule out a retinal tear or detachment

• There are recurrent bleeds that impair recovery

• You rely heavily on the affected eye (e.g. the fellow eye has poor vision)

• There is tractional retinal detachment, often seen in advanced diabetic retinopathy

Understanding the risks

Vitrectomy is generally safe in experienced hands, but as with any surgery, there are potential risks. These include cataract progression, retinal tears or detachment, infection, and raised intraocular pressure. Therefore, surgery is usually reserved for cases where the benefit outweighs the risk — for example, where vision is severely affected and unlikely to recover with observation alone.

At DS Eye Surgeon in Birmingham, we do not perform surgery on vitreous haemorrhage cases directly — but we can diagnose the cause, assess severity, and refer you appropriately if surgery is needed. We also manage many cases of diabetic eye disease, which is a leading cause of bleeding into the vitreous.

If you’ve experienced a sudden loss of vision, the most important step is to have a dilated fundus examination to determine whether surgery is needed — and if not, how best to monitor or treat the condition medically.

If you’ve had a sudden change in vision and suspect a vitreous haemorrhage, your options are:

• Emergency referral to BMEC casualty (for retinal tears, detachment or dense bleeds with no fundal view)
• Consultant-led private clinic (like DS Eye Surgeon) for:
• Same-day dilated retinal exams
• OCT imaging to assess the macula and vitreous
• Diabetic retinopathy treatment (laser/injections)
• Advice on next steps, referrals and monitoring

Our Birmingham clinic is located at Edgbaston Eye Consultants, 22 George Road, B15 1PJ, walking distance from Fiveways rail station and bus stop.

• Is vitreous haemorrhage an emergency? It needs urgent review because one of the causes is acutely sight-threatening— especially if your vision suddenly drops or you see flashing lights or shadows. You need an urgent eye exam to rule out a retinal tear.
• Can vitreous haemorrhage go away on its own?  Yes, small bleeds often clear without treatment over weeks or months. But the underlying cause must still be checked and treated.
• Will my vision return to normal? In many cases, yes — especially if no permanent retinal damage occurred. But floaters or minor haze may persist long-term.