How should I diagnose a punctate or flame-like hemorrhage in the fundus of the eye?

  Fundus hemorrhage is not an independent eye disease, but a feature shared by many eye diseases and certain systemic diseases. It is commonly seen in retinopathy due to hypertensive retinopathy, diabetes mellitus and nephropathy. Retinal perivasculitis, retinal vein obstruction, optic disc vasculitis, and hematologic diseases cause retinopathy, and fundus hemorrhage from ocular trauma. Due to various etiologies leading to the same pathological damage, such as retinal hemorrhage, exudation, microangioma, neovascularization, etc.  The disease has a long course and is prone to recurrent attacks because of its complex etiology, which seriously affects vision and causes many serious complications. Such as macular degeneration (macular cystoid edema, macular degeneration), neovascular glaucoma, vitreous hemorrhage, optic nerve atrophy, proliferative retinopathy, retinal detachment, if not timely and effective treatment, can often lead to blindness.  The diagnosis can be made based on these symptoms: 1. Sudden darkness in front of the eyes, only manual or light perception.  2.Suddenly, there is a round black shadow in front of the eyes, not floating with the eye rotation, the central direction of the gaze object is completely missing, the two sides of the object is blurred visible.  3.Suddenly, there is a black shadow like a line in the eye shooting in a certain direction, progressing rapidly and gradually increasing, and finally covering the front of the eyes, and the vision is blurred and indistinguishable.  4.Suddenly there is a flash of red light in front of the eyes, gradually increasing, so that the red light is full of eyes and the vision is unclear.  5. The onset of the disease is usually preceded by a feeling of eye swelling and eye fluttering.  6.Most of the recurrent attacks, each attack, there are also some of the above symptoms, even if the accumulation of blood does not recede, when the bleeding continues, there may also be some of the above feelings.  Due to the different causes and locations of fundus hemorrhage, the prognosis and the impact on the patient’s vision are different, and the symptoms vary according to the amount and location of the hemorrhage. If the hemorrhage is small and located in the optic papilla and the peripheral part of the retina, there may be no obvious symptoms. If the hemorrhage is large, the patient may feel a black shadow floating in front of the eyes, and the vision is partially or completely blocked, leaving only a light sense of vision. If the hemorrhage is located in the center of the retina (macular area) the patient loses central vision, i.e., the central area has dark shadows obscuring the vision, and the periphery still has partial vision.