Several weeks ago, one of the blood vessels hemorrhaged in my eye and a retina specialist had to laser it to stop the bleeding. The old blood floating around in the vitreous gel makes it impossible to see out of the eye. The doctor told me it will clear up, but it may take months. I am scared I'll never see out of that eye again. What are the odds of my vision returning to normal?

Carol

You do not say if you have diabetes. However, one of the most common causes of hemorrhaging in the eye is the elevated blood sugar associated with poorly controlled diabetes. High blood sugar leads to the gradual damage of the blood vessels inside the eye (specifically the retinal blood vessels), resulting in the development of leaks. When the early signs of diabetic damage to the retina are seen in an eye exam, doctors refer to the condition as "background" diabetic retinopathy.

The most dreaded retinal complication from diabetes occurs when tiny, fragile vessels sprout from the retina and grow up into the gel of the eye (almost like vines). These blood vessels are prone to rupture. If identified early, laser treatment can be performed to stimulate their regression. However, without proper treatment, the blood vessels will grow, and then rupture. This leads to hemorrhage within the vitreous gel. Such hemorrhages may clear on their own. But the process may take weeks or even months, often severely impairing vision during that time.

Besides temporarily affecting a patient's eyesight, a vitreous hemorrhage can prevent doctors from applying laser treatment to the retina to spur the regression of abnormal blood vessels. Such vessels may then continue to grow, and sometimes this can lead to a retinal detachment and/or further hemorrhaging into the retina.

The decision to surgically remove blood from the vitreous must be made in conjunction with a retinal specialist. Doctors and patients should carefully weigh the risks of surgery with the risks of waiting for the hemorrhage to clear on its own. Risks of surgery include infection, severe inflammation, cataract formation and retinal complications. The risks of continued waiting include poor vision in the eye and further worsening of the retinal condition by the fragile blood vessels.

As far as the chances of your vision returning to normal, in most situations the blood will eventually clear, leaving your vision similar to its pre-hemorrhage state. However, many patients with vitreous hemorrhages caused by diabetic retinopathy may also suffer from swelling of the retina or other problems. Since many of the retinal problems associated with diabetes can be treated if caught in time, it is crucial that all people with diabetes have annual eye exams.