Because vitreous hemorrhage is not
necessarily associated with any specific activity (although it
can be associated with strenuous physical activity), people with
diabetes are encouraged to lead a normal life and not restrict
their physical activities for the sake of their eyes. There may
be exceptions to this general rule, and your doctor will help
advise you. When a person does notice the sudden appearance of
floaters, spiderwebs, spots in front of the eye, or blurred
vision, they should immediately call their eye doctor.
It is often helpful for someone with diabetes who develops a
vitreous hemorrhage to remain in a sitting position so that
gravity can help settle the blood to the lower parts of vitreous
cavity. Once the blood settles, panretinal laser
photocoagulation can be done. Laser surgery cannot make the
blood disappear, but it can cause the neovascularization that
bled to shrink and thereby prevent more bleeding into the
vitreous. The vitreous hemorrhage that is present usually
disappears with time but can take many months to clear.
is so much vitreous hemorrhage that laser surgery is not
possible, or if the blood does not disappear on its own, it can
be removed with an operation called a vitrectomy.
Vitrectomy surgery is done in the hospital, under general or local
anesthesia. The blood-filled vitreous gel is removed. It is
replaced during the operation with a gas bubble or a clear fluid
that is compatible with the eye. Over time, the gas bubble or
fluid is absorbed by the eye and is replaced by the eye's own
fluid, although the eye does not replace the gel itself. The
lack of vitreous gel does not affect the function of the eye. If
the blood in the vitreous does not go away on its own, your
doctor will advise you as to how long you should wait before
vitrectomy surgery is considered.