Subhyaloid retinal hemorrhage = bleeding that sits between the retina and the vitreous gel (just beneath the thin “hyaloid” layer on top of the retina).
What it looks like
- On fundoscopy it appears as a well‑defined, boat‑shaped or dome‑shaped red‑purple patch behind the retina.
- The blood is usually bright red because it’s relatively fresh and sits in a pocket that doesn’t mix with the vitreous.
Common causes
Clinical clues
- Symptoms: Sudden blurred vision, a dark “spot” or “shadow” in the visual field, sometimes a scotoma. If the bleed is large, it can cause a vitreous hemorrhage and markedly reduced vision.
- Location: Usually posterior pole (macula‑adjacent), but can occur anywhere the retina meets the vitreous.
Management approach
- Identify & treat the cause – control hypertension, manage diabetes, stop/reverse anticoagulation if possible.
- Observe – many small subhyaloid bleeds reabsorb on their own within weeks to months.
- Laser or cryotherapy – may be needed if there’s an underlying retinal tear or neovascularization.
- Vitrectomy – indicated for large, non‑clearing hemorrhages (especially if vision is < 20/200 or there’s traction on the retina).
- Follow‑up – regular fundus exams to monitor resolution and check for complications (e.g., macular scar, retinal detachment).
Prognosis
- Small bleeds → usually good visual recovery once they clear.
- Large or recurrent bleeds → risk of permanent macular damage, especially if the hemorrhage dissects into the vitreous or causes traction.
Bottom line: Subhyaloid retinal hemorrhage is a bleed trapped between the retina and vitreous, often caused by vascular stress, trauma, or systemic disease. Management hinges on treating the underlying cause and deciding whether observation, laser, or vitrectomy is needed based on size and visual impact.


