Hemorrhage may be described as an abnormal, severe, internal or external discharge of blood. Intraocular hemorrhage occurs within the eyeball.

Included among the causes of the condition may be: trauma, straining, sneezing, coughing, unknown, or associated with blood dyscrasias.

Subconjunctival hemorrhages appear as gross extravasations of blood beneath the conjunctiva. Vitreous hemorrhages are extravasations of blood into the vitreous body. Under an ophthalmoscope, a black reflex is produced. Retinal hemorrhages in the superficial nerve fiber layer appear flame-shaped. Deeper hemorrhages appear as round dots and blots.

Tests that may be used include: visual fields, visual acuity, ophthalmoscopy, and ultrasonography.

Subconjunctival hemorrhages absorb spontaneously within a few weeks. No specific treatment is required. Vitreous hemorrhages may need to be controlled by photocoagulation or vitrectomy. Hemorrhages in the retina due to hypertension (see diagnostic code: 7101 hypertension), or diabetes mellitus (see diagnostic code: 7913 diabetes mellitus) are usually managed by medical control of the diseases.

Ocular complications may produce irreversible loss of vision, and visual symptoms will vary depending on the pathologic events.

• Consider entitlement to Auto and auto adaptive equipment under 38 CFR 3.308 if there is permanent impairment of vision in both eyes consisting of central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20° in the better eye.

• Consider entitlement to specially adapted housing under 38 U.S.C. 2101(a)(2)(A)(i) if there is visual impairment to the degree specified in 38 CFR 3.809(b)(2).

• Review for potential entitlement to special monthly compensation under 38 CFR 3.350 when there is loss/loss of use of one or both eyes, light perception only; visual acuity 5/200 or less; the vision field is reduced to 5 degree concentric contraction in both eyes; or blindness with no light perception in one or both eye.

• Evaluate on the basis of either visual impairment due to the particular condition or on incapacitating episodes, whichever results in a higher evaluation.

• For the purposes of evaluation under 38 CFR 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes.

• Examples of treatment may include but are not limited to: Systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions.

• For the purposes of evaluating visual impairment due to the particular condition, refer to 38 CFR 4.75, 38 CFR 4.76, 38 CFR 4.77, 38 CFR 4.78,  and  38 CFR 4.79, diagnostic codes 6061-6091.