Retinal Bleeding in Cats

Depending on the severity of retinal bleeding, there may be no obvious symptoms of the condition until blindness occurs. Regular veterinary check-ups increase the chance that potential vision problems will be detected in time for treatment to be effective. If a cat displays abnormal behavior that may indicate a loss of vision it is critical to seek medical attention as soon as possible.

The retina is the internal lining of the eyeball that interprets light impulses and sends visual information to the brain. When bleeding occurs in this area it is known as retinal hemorrhage. The condition usually indicates the presence of an underlying disease which is often more serious than the hemorrhage itself. Bleeding may occur in one eye or both and is often accompanied by inflammation. Retinal detachment may occur and is likely to lead to blindness if not addressed immediately.

Cats displaying any of the following symptoms may be experiencing retinal hemorrhage:

• Vision loss / bumping into objects
• White pupils
• Dilated pupils
• Reluctance to go outside
• Body bruises
• Bloody urine or feces

If blood from the retinal area spreads forward, inflammation may be visible in the front of the eye. It may appear red or cloudy and squinting is likely to occur. If vision impairment affects only one eye, the cat may not show any signs of abnormal behavior.

Retinal bleeding may be caused by genetic disorders such as a deformity of the retina or problems with eye lubrication. Other possible causes include:

• Trauma or injury
• High blood pressure (more common in older cats)
• Kidney disease
• Heart disease
• Abnormally high thyroid levels
• Clotting disorders
• Increased steroid levels
• Chemical exposure
• Fungal or bacterial infection
• Cancer or Leukemia 
• Blood disorders
• Liver disease
• Diabetes
• Blood vessel inflammation
• Radiation therapy

Prior to completing a complete physical exam, the veterinarian will want to review the cat’s full medical history and discuss details regarding onset of symptoms. If owners have theories regarding possible causes of the symptoms, this should be shared at the beginning of the appointment. Standard lab tests will likely be ordered to assess the cat’s overall health and check for underlying medical conditions. This includes a complete blood count (CBC), electrolyte panel, blood pressure test, urinalysis, and thyroid test. Heart and/or abdominal ultrasounds may also be recommended.

A full ophthalmic exam will be needed, and the vet is likely to use a slit lamp microscope to visualize the back of the eye and measure electrical activity in the retina. An ultrasound of the eye and lab testing of eye fluid samples may also help with diagnosis.

Treatment recommendations will vary depending on the severity of the bleeding, whether the retina has detached, and the underlying causes associated with the condition. Hospitalization and intense care by a veterinary ophthalmologist is likely to be necessary. In most cases, corticosteroids will be prescribed to address inflammation. Nonsteroidal anti-inflammatory medications (NSAIDS) should not be used as they can cause the condition to worsen.

Addressing Underlying Conditions

A variety of medications may be used to treat underlying conditions. High blood pressure is a common cause of retinal bleeding that must be controlled for a variety of reasons. Blood pressure medication, I.V. fluids, and anti-inflammatory drugs are commonly prescribed. Other medications and treatments include antibiotics or antifungals, blood clotting treatments, insulin for diabetes, and thyroid treatments. Chemotherapy may be needed for leukemia or other forms of cancer.

Repairing Retinal Detachment

If the retina has detached, surgery will be needed. The veterinarian will assess the condition of the eye to determine if reattachment is an option. If the eye has suffered a serious injury or tumors are present, removal of the eyeball may be necessary. Cats generally adapt to the loss of an eye within a few weeks.

Frequent follow-up appointments will be needed to track the condition of the retina and the progression of the underlying disorder. Small hemorrhages usually resolve on their own within a few weeks or months. If the bleeding is more extensive, it may take longer to heal and the possibility of retinal detachment will continue to be a concern. Bloodwork and eye exams will be needed on a regular basis.

If surgery has been performed, the cat should rest as much as possible and be kept to a confined area while recovering. Once the condition has been resolved, any associated pain should subside. If blindness has occurred, the condition will be permanent. However, cats with vision loss are often able to adapt by memorizing the layout of their environment and should be able to maintain a high quality of life. Blind cats will be extremely vulnerable to unseen conditions, so it is critical that they remain indoors and are kept out of the reach of other pets and young children.