Hemorrhages in the various layers of the retina are either due to some systemic predisposing factors or due to sudden shearing stress over the vessels and very rarely spontaneously. Sub ILM hemorrhage is considered a part of the pre-retinal type of vitreous hemorrhage. Retinal hemorrhages: Retinal hemorrhages are classified depending on the site of bleeding- Sub RPE hemorrhage(between the RPE and Bruch's membrane), Sub-retinal hemorrhage(Between the RPE and neurosensory retina), Intraretinal hemorrhage (Dot and Blot hemorrhages), and RNFL hemorrhage (Flame- shaped hemorrhage, Roth spots, splinter hemorrhages ).
Īnother hypothesis states that when sudden hypotony occurs, patients who already have damaged or weak posterior ciliary arteries have chances of rupture and bleeding into the suprachoroidal space. Shaken baby syndrome incidence is between 15 and 30 per 100 000 children under the age of 1 year. 52% of their patients had past history of Age-Related Macular Degeneration. showed that the incidence of submacular hemorrhage was 5.4 per million per annum. In a study by Obuchowska et al., it was discussed that the incidence of suprachoroidal hemorrhage after all ocular surgeries was 0.29%. The incidence and prevalence of intraocular hemorrhage are directly correlated with the incidence and prevalence of the predisposing factor, which leads to the bleeding. Other causes accounting for the rest of 16% included posterior vitreous detachment, retinal vasculitis, sickle cell retinopathy, ARMD, tumor, retinopathy of prematurity, leukemias, acute retinal necrosis, HIV related retinopathy, and rarely patients of uveitis. In a study by Butner et al., it was noted that in patients of vitreous hemorrhage, 34.1% of the cases were of diabetic retinopathy, 22.4% of patients were of a retinal break without retinal detachment, 14.9% cases were of rhegmatogenous retinal detachment, and 13% cases were of retinal vein occlusion. The incidence of traumatic hyphema in children is around 70%, with 10-20 years of children being more affected. The incidence of traumatic hyphema is approximately 12 injuries per 100,000 population. Males are three to five times more affected than females. Traumatic injury is more common in children during the summer season owing to increased outdoor activities during summer vacations. However, traumatic injuries are more common in young males owing to more outdoor activities and heavy work. It can occur at any age and without any gender predisposition. Traumatic eye injury can cause shearing force over the normal blood vessels and can rupture them causing an ocular bleed.
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