Post-Vitreous Surgery: New Eye Bleeding Concerns

Q: Post-Vitreous Surgery: New Eye Bleeding Concerns

Hello： Based on what you mentioned, this is just my preliminary opinion without a physical examination. <br>The best course of action is to have an eye examination to ensure you receive the most accurate diagnosis and treatment recommendations. <br><br>1. <br>Regarding the issue

Recurrent intraocular hemorrhage after vitrectomy?

My wife underwent a vitrectomy on January 11, and today, January 15, she returned for a follow-up appointment to receive an injection.
The doctor did not specify what type of injection it was, but mentioned that the cost is not in the range of one or two thousand.
The doctor also indicated that her condition is progressing positively, although her vision is limited to counting fingers.
However, later in the evening, my wife noticed what seemed to be bleeding in her eye, as she observed a red area when looking out.

I would like to ask: 1.
Is the bleeding a result of the injection? She experienced less pain with the injection on January 8 compared to today's injection, which was more painful (despite being the same type of injection).
2.
Could this be due to retinal neovascularization causing a rupture and subsequent bleeding?

Mr. Wang, 50~59 year old female. Ask Date: 2024/01/16

Dr. Gao Pilin reply Ophthalmology

Hello: Based on what you mentioned, this is just my preliminary opinion without a physical examination.
The best course of action is to have an eye examination to ensure you receive the most accurate diagnosis and treatment recommendations.

1.
Regarding the issue of eye bleeding, it may be caused by various factors.
However, if there is new pain or new bleeding, further evaluation may be necessary.
Please take note of these symptoms and inform your ophthalmologist about the pain and bleeding so that appropriate management can be provided.
2.
A rupture of proliferative retinal blood vessels may lead to bleeding, but this also requires further examination to confirm.
Please seek an eye examination as soon as possible to ensure you receive appropriate diagnosis and treatment.

Reply Date: 2024/01/16

More Info

After undergoing vitreous surgery, it is not uncommon for patients to experience concerns regarding new bleeding or changes in vision. Your wife's situation, particularly the observation of a red area in her vision following the injection, raises several important points that need to be addressed.

1. Post-Injection Bleeding: It is possible that the bleeding observed after the injection could be related to the procedure itself. Intraocular injections can sometimes lead to localized bleeding, especially if there was any trauma to the delicate tissues within the eye during the injection process. The fact that your wife experienced more pain with this injection compared to the previous one could indicate that there was some irritation or trauma to the eye. However, it is essential to differentiate between normal post-injection effects and more serious complications. If the bleeding is significant or accompanied by worsening vision, it is crucial to seek immediate medical attention.

2. Retinal Vascular Issues: The concern regarding whether the bleeding is due to a rupture of abnormal blood vessels associated with retinal neovascularization is valid. Patients who have undergone vitreous surgery, especially for conditions like diabetic retinopathy or retinal vein occlusion, may have fragile new blood vessels that can bleed easily. If these vessels are compromised, it could lead to new bleeding episodes. The timing of the bleeding, occurring shortly after surgery and an injection, could suggest that the underlying condition is still active and may require further intervention.

3. Monitoring and Follow-Up: It is essential to maintain close communication with the ophthalmologist regarding any changes in vision or new symptoms. The doctor may recommend additional imaging studies, such as optical coherence tomography (OCT) or fluorescein angiography, to assess the status of the retina and any potential bleeding sources. These tests can provide valuable information about the health of the retina and the presence of any abnormal blood vessels.

4. Management of Symptoms: If your wife is experiencing pain or discomfort, it is important to manage these symptoms appropriately. Over-the-counter pain relievers may help, but any persistent or severe pain should be evaluated by a healthcare professional. Additionally, if there are any signs of increased redness, swelling, or discharge from the eye, these could indicate an infection or other complications that require prompt attention.

5. Long-Term Outlook: The prognosis after vitreous surgery can vary significantly depending on the underlying condition being treated and the overall health of the retina. While some patients experience significant improvements in vision, others may have ongoing challenges. Regular follow-up appointments are crucial to monitor the healing process and address any emerging issues.

In summary, while it is possible that the bleeding observed after the injection is related to the procedure, it is also important to consider the potential for ongoing retinal vascular issues. Close monitoring and communication with the ophthalmologist are essential to ensure the best possible outcome for your wife's vision and overall eye health. If there are any concerns about the severity of the bleeding or changes in vision, do not hesitate to seek immediate medical advice.

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