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What does blood in the back of the eye signify, anyway?

It could be a retinal vein occlusion, an ocular disorder that can occur in older people when the blood vessels to the retina are blocked.

The retina is the back part of the eye where light focuses and transmits images to the brain. Blockage of the veins in the retina can cause sudden vision loss. The severity of vision loss depends on where the blockage is located.

Blockage at smaller branches in the retinal vein is referred to as branch retinal vein occlusion (BRVO).  Vision loss in BRVO is usually less severe, and sometimes just parts of the vision is blurry.  Blockage at the main retinal vein of the eye is referred to as central retinal vein occlusion (CRVO) and results in more serious vision loss. 

Sometimes blockage of the retinal veins can lead to abnormal new blood vessels developing on the surface of the iris (the colored part of your eye) or the retina. This is a late complication of retinal vein blockage and can occur months after blockage has occurred. These new vessels are harmful and can result in high eye pressure (glaucoma), and bleeding inside the eye.

What are the symptoms of a retinal vein occlusion?

Symptoms can range from nothing to painless sudden visual loss. Sudden visual loss usually occurs in CRVO. In BRVO, vision loss is usually mild or the person can be asymptomatic. If new blood vessels develop on the iris, then the eye can become red and painful. If these new vessels grow on the retina, it can result in bleeding inside the eye, causing decreased vision and floaters – spots in your vision that appear to be floating.

Causes of retinal vein occlusion

Hardening of the blood vessels as you age is what predisposes people to retinal vein occlusion.  Retinal vein occlusion is more common in people over the age of 65. People with diabetes, high blood pressure, blood-clotting disorders, and glaucoma are also at higher risk for a retinal vein occlusion.

How is retinal vein occlusion diagnosed?

A dilated eye exam will reveal blood in the retina. A fluorescein angiogram is a diagnostic photographic test in which a colored dye is injected into your arm and a series of photographs are taken of the eye to determine if there is fluid leakage or abnormal blood vessel growth associated with the vein occlusion. An ultrasound or optical coherence tomography (OCT) is a photo taken of the retina to detect any fluid in the retina. 

Treatment for retinal vein occlusion

Not all cases of retinal vein occlusion need to be treated. Mild cases can be observed over time. If there is blurry vision due to fluid in the retina, then your ophthalmologist may treat your eye with a laser or eye injections. If new abnormal blood vessels develop, laser treatment is performed to cause regression of these vessels and prevent bleeding inside the eye. If there is already a significant amount of blood inside the eye, then surgery may be needed to remove the blood.

Outlook after retinal vein occlusion

Prognosis depends on the severity of the vein occlusion. Usually BRVO has less vision loss compared to CRVO. The initial presenting vision is usually a good indicator of future vision. Once diagnosed with a retinal vein occlusion, it is important to keep follow-up appointments to ensure that prompt treatment can be administered to best optimize your visual potential.

Motherhood...the sheer sound of it brings enduring memories. A mother’s touch, her voice, her cooking, and the smile of approval in her eyes. Science has proven that there is a transference of emotion and programming from birth and infancy between a mother and her child--a type of communication, if you will, that occurs when the infant looks into its mother’s eyes. So what is this programming? How does it work and what effect does it have on the life of the child? What happens if it never happened to the infant? What happens if the mother is blind?

The gaze into a mother’s eyes brings security and well being to the child. When she gazes at another person, it makes the infant look at what she is gazing at, and introduces the infant to others in the world. This is known as a triadic exchange. So now the baby's world is no longer just one person--its mother--but also includes third parties, thereby increasing social skills and interaction.

Interestingly, if a mother is blind, it does not adversely affect the child’s development. A study published in the Proceedings of the Royal Society B showed no deficit in the baby's advancement. The sheer fact that the infant looks into the mother’s eyes helps with connectedness and emotional grounding.

Looking into mom’s eyes and face teaches facial recognition and expressions of emotions and is primarily how the child learns in the first few months of life. Additionally, infants tend to show a preference to viewing faces with open eyes rather than closed eyes, thus stressing the importance of the mother or caregiver’s gaze.

Some health benefits to gazing into the mother’s eyes is a lower incidence of autism, or spectrum disorders, and better social skills, higher learning capacity, and emotional groundedness.

The beauty of a mother’s gaze is that the child can feel the emotions of love, security, safety, and overall well-being by connecting with her through eye-to-eye contact. This sets the stage for the future development of social skills, visual recognition of people, and readiness for social interaction in the world.

A big thank you to science and mothers for proving what we already know--that the values in life can be taught to a child “through a mother's eyes,” setting the course for proper interaction for life skills and relationships.

References:

1. Kate Yandell, Proceedings of the Royal Society B ,04/10/2013.

2. Maxson J.McDowell, Biological Theory, MIT Press, 05/04/2011.