Vitreous Haemorrhage with No Retinal Detachment, No Retinal Break, and No Proliferative Neovascularisation
This protocol applies when vitreous haemorrhage has been confirmed in the absence of concurrent retinal detachment, retinal break, and retinal neovascularisation from proliferative retinopathy — a specific sub-population in which the approach to management differs meaningfully from cases where these findings are present.
Clinical Scenario
No retinal detachment
No retinal break
No proliferative neovascularisation
Provided the retina is attached and neither a break nor neovascularisation is identified, management is conducted on an outpatient basis. Where retinal detachment has been excluded, patients may return to normal activities, subject to the clinical picture.
Approach (partial overview)
The initial strategy is observational — focused on allowing the haemorrhage to reposition naturally.
The complete protocol, including specific activity and positional guidance and the full decision pathway, is available via the link below.
Treatment Goals
- Inferior settling of the vitreous haemorrhage
- Restored visualisation of the retina
References
Provided the retina is attached, observation is on an outpatient basis.
If a retinal detachment has been ruled out, patients may return to normal activities.
If the view to the posterior pole is blocked, limitation of activities and elevation of the head of the bed while sleeping may allow the blood to settle inferiorly and permit visualisation of the superior retina where retinal breaks most commonly occur.
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