Diagnosis and Management of Bleeding Vitreous by Trauma Closed Eyeball

Rika Anggraini, Ak Ansyori, Ramzi Amin
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Abstract

Introduction. Diagnosis of vitreous bleeding is generally straightforward and  it can be made through history, ophthalmological examination and fundoscopy. However, the management is determined by the underlying etiology. The most common causes as factors that cause opposite vitreous bleeding include retinopathy of proliferative diabetes, posterior vitreous detachment (PVD) and trauma in 59-88.5% of cases. Reported a case of vitreous hemorrhage due to closed eyeball trauma performed by pars plana vitrectomy and endolaser with significant vision improvement. Case Presentation. A male, 21 years old, student, lived in suburban, came to the Polyclinic of RSMH on July 2019. Approximately 1 month ago the patient complained that his right eye vision suddenly felt blurry after being hit by volleyball from the front from a distance of 1 meter while playing volleyball with his friends. Patients complain of the view of the right eye as if it were covered with a red shadow accompanied by pain around the right eye. Ophthalmological examination obtained vision of this patient is a wave of the hand that is 1/300 in the right eye and 6/6 in the left eye that shows the disorder is unilateral with a fairly poor decrease in vision. During intraoperative right eye hemorrhage was found to nearly cover the retina with the source of bleeding in peripheral retinal blood vessels which when found intraoperatively were not found extravasation or active bleeding. Conclusion. The operative action of pars plana vitrectomy gives a clinically significant result that is obtained very good sharp eyesight and from the examination results obtained echofree on vitreous. Proper timing is very important in determining the management of vitreous bleeding in order to get good results and minimize the risk of complications that can occur.
闭眼外伤玻璃体出血的诊断与治疗
介绍。玻璃体出血的诊断通常很简单,可通过病史、眼科检查和眼底镜检查来确定。然而,治疗是由潜在的病因决定的。导致对侧玻璃体出血的最常见原因包括增殖性糖尿病视网膜病变、玻璃体后脱离(PVD)和创伤(59-88.5%)。报告1例闭合性眼球外伤玻璃体出血,经玻璃体切割及激光治疗后视力明显改善。案例演示。男性,21岁,学生,住在郊区,于2019年7月来到RSMH综合诊所。大约1个月前,患者抱怨与朋友打排球时,在距离1米远的地方被前方的排球击中,右眼视力突然模糊。患者主诉右眼视界好像被红色阴影覆盖,右眼周围疼痛。眼科检查显示,该患者的视力为右眼1/300,左眼6/6的手部摆动,显示该疾病为单侧,视力下降较差。术中发现右眼出血几乎覆盖视网膜,出血源在视网膜周围血管,术中未发现外渗或活动性出血。结论。玻璃体平滑肌部切除术的手术效果具有重要的临床意义,可获得良好的锐利视力,玻璃体无回声。适当的时机是决定玻璃体出血处理的重要因素,以获得良好的效果并尽量减少可能发生的并发症的风险。
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