Small haemorrhage by optic nerve

[Maisie79]

I recently went to my opticians for an eye health check because I’d been having pain and occasional white fogginess in my right eye. I have NTG in both.

The OCT scan revealed a small bleed by the optic nerve in my right eye. The optician said it could be caused by a floater having attached itself then pinged off a small blood vessel but they do happen in people with NTG, so could be that? Follow up there in 4 weeks to repeat the scans and do a full eye test.

He said that the bleed wouldn’t cause pain or the white fogginess? So I’m no nearer understanding what’s happening there.

I have my follow up consultant appt in a few weeks.

Has this happened to anyone else with NTG? The white patches or small bleeds? I’m on Monopost drops with Theoloz Duo to ease the soreness.

Any advice greatly appreciated ⭐️

[Blindbatuk]

Hi Maisie,

This isn’t going to help much but I had a few retinal vein occlusions (haemorrhages) back in 2010. It was picked up on an early version of OCT and I was referred to Moorfields.

I still don’t know if it was related but I was in a hotel in Singapore on a work trip and had really acute stabbing pain in my head and my sight went blurry. It last a few hours. It was when I visited my optician a few weeks later in the UK that he spotted it.

Moorfields couldn’t detect what had caused the haemorrhaging ( I seem to recall there were two or three) and took lots of bloods over the course of a few weeks. They didn’t show any issues so they then sent me for an MRI to see if anything was pushing against the veins but this drew a blank too. Eventually after a year or so the occlusions cleared up on the scans. We never got to the bottom of it.

I have open angle glaucoma in both eyes.

Best of luck! Come back and tell us.

[Maisie79 in reply to Blindbatuk]

Thank you for sharing! Much appreciated. Very glad to hear it cleared up for you.

I’m hoping it’ll have cleared by my next scan and that will be the end of it. Fingers crossed.

[Beecalmed]

I have POAG and as I have progression on low eye pressures and due to other indicators I’m suspected as NTG. One of those indicators is regular retinal bleeds. Some research into NTG and retinal bleeds suggested that the bleeds may proceed a deterioration in nerve damage. I think the average lead in was 1 year to 18 mths after. I would make sure your glaucoma specialist is aware of the bleed and they will likely check you more frequently and may want to adjust your treatment.

I can empathise as after a long period without bleeds I’ve just had a bleed spotted and my optician has notified my consultant who I’m waiting to see in case repeat laser might be advisable or maybe my drops need changing.

We’re all different though and a bleed may have no significance for you, but I would let my consultant know if you haven’t already just to be on the safe side. 👍🏻

[Maisie79 in reply to Beecalmed]

I hope you don’t have to wait too long for your appointment & I really appreciate you sharing your story. That’s really interesting information thanks. There’s so much to learn.

The optician did say these can be common for people with NTG but didn’t elaborate & at that point I just wanted to get the heck out of there.

Currently waiting to hear if consultant wants to see me sooner than January. Follow up with optician in 3 weeks. They’ve been brilliant to be honest.

Take care & best wishes

[Iona57]

Yes, I have had these small bleeds. I have normal tension glaucoma. They were picked up by the hospital when I was diagnosed in 2022. But they went, and I have had two or three more that came and went. I have discussed with my consultant and there doesn't seem to be a clear reason why they happen. However, It seems they can sometimes be an indication that the glaucoma is more unstable and more likely to progress . I've never had any visual symptoms associated with the bleeds.

[Maisie79 in reply to Iona57]

Hi, thank you for your reply. It’s so tricky to pick it all apart isn’t it?! Maybe the foggy patches aren’t related to the bleed. I definitely need to follow it up - I might try & see my consultant sooner. Peace of mind!

Best wishes

[muddledme]

Hello Maisie79,

I also have NTG and used to have frequent retinal bleeds, in fact almost every examination, these are apparently sometimes difficult to see. I always tell any medic looking at my eyes about this history and ask if they can see them.

My glaucoma did not respond to many medications or laser so eventually I had a Preserflo shunt in each eye which seems to have caused stability . Since these two ops in 2020 and 2021 I have only had two small bleeds, one whilst I was taking Vit B3 tablets and the other due to another eye condition (an Epi- retinal membrane).

I was never aware of the retinal bleeds.

If you still have sore eyes, I wonder if you have tried Thealoz Duo Gel at night ? For me these drops are very helpful.

Best wishes

[Maisie79 in reply to muddledme]

Hi, yes I have tried the gel - amazing! My GP won’t put it on prescription annoyingly. I should get some more in. Thanks for the nudge.

It seems these bleeds are quite common in NTG folks. I wonder why?

Very glad to hear the shunts are working. Do you think the B3 had anything to do with the bleed?

[muddledme in reply to Maisie79]

I told my GP that if I had the Thealoz Duo Gel then I will use far fewer Thealoz Duo UD and save the NHS funds!. So I now get the Gel on prescription and only very rarely need the Duo UD. This did take a bit of persuasion as I think they are often too busy to change the status quo.

Not sure about the Vit B3 but I was suspicious because bleeding may be a side effect( as with Ginko). I contacted the B3 research team in Moorfields who were helpful and interested ,they said that it was possible and one of the reasons for the research .

NTG does not seem to be well acknowledged by some opticians and even hospitals. Many staff are perfectly happy with my IOP in the high teens although the opthalmologists say that for me it should be lower. I often have to ask for the pressure results and have learnt to ask lots of questions.

I think there was an interesting Glaucoma UK Webinar covering NTG , hopefully still on You Tube.

Best wishes

[Nonswimmer]

I'm sorry I cannot advise on the drops you are using, I've replied because I have never heard of an eye health check at an opticians, is this in England? if so was it a private opticians?

I believe we should be able to go to the opticians to have pressures or OCT scans without having a full eye test because this year I've found it necessary to have 3 tests, 2 paid for privately.

[Maisie79 in reply to Nonswimmer]

I’m in Wales - you can get an eye health examination for urgent problems at any high street opticians as part of the NHS. It’s a fantastic service. They triage over the phone & say if you’re eligible. I’ve been seen twice this year. It is for urgent issues only though - but having glaucoma and being concerned about eye pressures, vision etc is reason enough I think.

I’ve never thought about it before but assumed we could just pay for a routine OCT without a full eye test? 🤔

Pretty sure I’ll have to pay for the follow up scan though.

[Nonswimmer]

Thank you, until recently if a consultant requested a visual acuity test opticians in England did an NHS eye test, this year I was told because of government changes I must pay for the test.