Direct cause of eye bleeds

I’m having trouble finding what the immediate cause of eye bleeds/floaters is. I’m not talking about the long-term complication of developing retinopathy… But what’s going on the exact moment a blood vessel starts leaking. What causes it to be healthy one moment, and leaking the next if it’s NOT blood sugar related?

When I was poorly controlled, I had frequent bleeds/floaters, that would dissipate and leave me with a constant foggy veil. I’ve never had my eyes lasered because the only facility in the area refuses to work with long-distance patient scheduling. They want 3 visits in a single week, all the last appointments of the day, long after the county’s medical transports quit operating. It’s too much to ask others to give up most of a week shuttling me across the state.

But it hasn’t mattered for a long time. Since getting CGM, Control-IQ, modern analog insulins, etc… and gaining incredible control, my eye complications have completely reversed. I’ve had absolutely clear vision for the last 4 years or so.

And suddenly this morning I woke with really bad haziness in one eye again. No active bleed, it must have happened during the night. Just the residual veil of dissipating blood. I’ve had an excellent week beforehand, though. Only 6 readings over 160 in the last 7 days, none at all in the last 3 days, nothing over 180 in the last two weeks, and I was perfectly flat between 103-117 when the bleed must have happened. So what in that exact instance could have happened to trigger the bleed if it wasn’t blood glucose?

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I have no insight or experience with this but wonder if blood pressure could have played a role. Do you take any blood thinners? Have you/your doctor looked at any blood clotting/coagulation factors like platelets? Could sleep apnea cause this? Do you ever consult with an opthalmologist?

I really don’t know, but could it be cataract?

Sorry you’re going through this. Hope you get some answers.

I don’t have high blood pressure. I take the standard (I think?) 5mg of Lisinopril to protect my kidneys. I’m not sure what could cause a blood pressure spike while sleeping. A scary dream?

My doctor’s have looked at everything under the sun! I have a mystery inflammatory condition nobody can figure out. There’s basically nothing wrong in any of my labs except I’m diabetic and have crazy levels of inflammation. They’re calling it “rheumatoid factor-negative RA”, but that seems like a cop-out. No coagulation issues.

I dunno, but I’ve had sleep studies done. I don’t have this.

Every year. He tells me my near-sighted prescription hasn’t changed and sends me on my way.

Definitely not. I recognize the pattern. When it happens, I can see a dense, dark “floater” where the bleed is… And then it dissipates into a thin, dark veil. The only way I can describe it is it’s very reminiscent of the Harry Potter movies, when the perspective is looking out through the cloak of invisibility and those scenes are filmed with a cloth over the lens.

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I had this explained to me by my eye doctor.
As diabetics our blood vessels can lose elasticity.
Our eyes will sometimes grow new capillaries to get more blood to places where flow is diminished.
New vessels are more fragile than old ones.

That’s why when your retinal photos show blood vessels growth, it’s a warning sign.

I had some growth a few years back but never a leak.
I just had my retinal photos taken yesterday. They took 8 shots instead of usual 2 with different angles.

I expect I’m fine but I always get a little anxious till I hear back.

I hope everyone is getting their photos taken.


I have been told same.

There have been times my dr does a very short/targeted laser treatment depending on what he sees. In some cases I didn’t even have vision changes to know it was there.

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I just got my results of my photos and nothing to report. They bumped me to every other year instead of every year.
Not sure if this is an issue of money saving or that my eyes are just so damn good !!!


Diabetes complications can be capricious foes and not everything that happens is related to diabetes. So it can be impossible to figure out why you with “good BG control” are having issues and others with cr*ppy numbers are doing fine. Joslin has been studying a group of 50-year medalists for many years to try to figure out why some people do fine despite longterm diabetes and others have devastating complications. Somewhere I think (and Joslin thinks) that there are unknown protective factors for some people with diabetes. I am sorry you’re dealing with vision issues because I know how educated you are and how hard you work at your diabetes.


Floaters aren’t normally bleeds, it’s particles that happen mostly as you age. But we had plenty of younger people come into the store that would get them. They have a tendency to go away with time and I know my brother in law got told by his eye doctor they would rotate out of sight after a while. I have never heard of a just a "floater’ causing cloudiness. Floaters should always be checked of course because it could be a sign of something more serious.

But usually floaters are from vitreous fluid. Blood vessels breaking are different. Some people are more prone to vessels breaking, varicose veins, spider veins, hemorrhoids, aneurysms are all weakened blood vessels. Some of these things seem to run in families. There are some supplements that help with the health of blood vessels overall.

I think partly why diabetes comes into play is because high sugar levels thicken the blood. The analogy I always remember was I was once told by a doctor that think of a fine mesh screen and pour water over it and it nicely goes through, but then think of syrup and how slowly it flows through. Then think of forcibly pushing through a thickened liquid and how the mesh will end up stretching to accommodate that. Over time that weakens the vessels. The eyes and the kidneys with all the small vessels seem to be the most prone to the damage caused by that.

Given that, I don’t know if is high blood sugar levels or just the act of having diabetes that can cause an issue. I’m not sure the doctors do either? We can hope we ease some of the side effects by good BG control.

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Thanks everyone for the input. I think I’m just frustrated because I have an appointment next week with the retina specialist. I was expecting some hoopla about retinopathy remission, because my vision has been just great… And then this happens right before the appointment.

I’ve been trying so desperately hard to be healthy! I love my life and want to be able to enjoy it.

I forgot what it was like to walk around with one eye half-functional. It completely messes with your depth perception, because your brain is getting wrong site signals. I’m quite literally a walking tornado leaving a path of destruction behind me. I’ve practically been grounded, since there’s little I can break in the bedroom. And the headache! It’s hard to remember this was the norm before I really started caring (or just got old enough to realize I’m not immortal).

Then maybe I’ve been calling my “floaters” by the wrong name? I can actually see when my eyes bleed. It will look like thread-like black spots. They move all around as I move my eyes, like they’re floating through the jelly… Hence why I thought they were floaters. I can see if they’re still bleeding or not based on if they’re growing/changing, and how dark the spot is. I can also watch the spots dissipate like smoke. It’s just the blood spreading out into the vitreous fluid. If they don’t continue to bleed, the veil will clear completely in short time. I never knew “floaters” referred to something different.

I’ve freaked my husband out a time or two when he’s caught me with my good eye closed, rolling the bad one around while staring into the inside of my eyeball… evaluating the bleed. It’s apparently disturbing, LOL.

I really appreciate this sentiment. Unfortunately, like most “educated” people, I’m just as ignorant of most things as I am schooled in a few. I still don’t understand what causes them to bleed.

For 30 some years I’ve had this half-baked idea that big clumps of sugar poke holes in the back of your eyes, because that’s how it was explained to me as a child. Now, that just seems absurd, but I still don’t know much better. I get the formation of new blood vessels and that they’re fragile… But not what it is that actually breaks them, if it’s not elevated BG.


What Timothy said. They grow in weak and they leak and bust. I have always had issues after I have lifted something heavy or strained pushing or pulling things. My surgeon said lots of diabetics say the bleed happens after they did this, but she always insisted it was not related to any specific activity. They used to say rapidly improved BG can cause a retinal leak. This was in the books for years. I don’t know if they still say it. I have had laser and about three injections over the years. The worst part about it is I see coffee ground speckles and I have had as much as a whole year needed for them to go away. It depends if the leak goes into my field of vision or off sideways. It’s a pain. Some scientific genius needs to invent a more rapid remedy so the junk absorbs quicker.

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I think you should definitely see your opthalmologist at the earliest possible. My retinol specialist always tells me to call him at the slightest change in my eyes, as he considers it an emergency. The earlier you correct the problem the higher chance you have to save your vision. I see my Dr every 6 months now, but I was going every month, each time they take a full set of eye images to compare with earlier ones. At least you need to get images taken, as @Timothy suggested. Good luck, I hope it is just floaters which I’ve been told, disolve on their own (though I’ve had one for about a year which has not changed at all!).

I want to chime in and suggest you see a rheumatologist immediately. (For a rheumatologist immediately may be 6 months). If you RF level is very high you need to evaluated for a menu of possible rheumatology diseases.

Type 1 and Rheumatology issues can run together. I do not believe that this might be the cause of the eye issues you are describing. (hang on more on RA and eyes in the next paragraph). But I do think you need to see a rheumatologist because only a Rheumatologist can accurately diagnose rheumatology issues. A high RF should not be ignored.

Now about RA and eye issues. What you describe is not generally in the realm of RA involvement. But yes RA and other rheumatology issues can impact our eyes. Here is a link to a brief article about RA and eyes.

Again what you describe is not that. But inflammation is a strange thing what is expected is not what is always seen.

Many blessings rick

Unfortunately, I’m completely negative for rheumatoid factors. My doctor insists some forms of RA don’t test positive for them… But that’s why I said it feels like a cop-out. Like, we can’t figure this inflammation thing out, so we’ll just chuck her in with the RA people. The questionable diagnosis is solely based on the number of joints involved.

I’ve been trying since pre-covid to get into the only rheumatologist out here. Still nothing on the books. I literally think we’re just waiting for some of her patients to die off or move on.

I am sorry i misunderstood. Your doctor is correct that not all people with RA have a positive RA factor result. Rheumatology is a tough condition to diagnose that is why it has to be left to a rheumatologist. While i misunderstood the statement about RA factor I would still ask to be referred. There are around 100 types of arthritis, It takes a rheumatologist to understand how to accurately assess the issues.

best rick

Oh gosh, I’m so sorry, Robin. I’ve gone through a bunch of this as well and it sucks. I hope yours clears quickly! As for direct cause, my first and worst bleed occurred after great sex with my husband. (How cruel is this stupid disease?) I guess that lines up with the heavy lifting idea in terms of vascular pressure changes? Again, heartfelt empathy. Boo.


I’ve been a T1D for over 55 years. At about 40 years, I had one incident of a blood vessel in the eye breaking and flooding the eye with blood, blocking vision in that eye. The blood eventually disappeared, but I think it took a number of weeks.

I remember sleeping sitting up during that time, the idea being gravity would help pull the remaining blood below my retina. My sense talking both with my Endo and my Opthamologist was it was caused by blood pressure issues, which have since been corrected and this has never happened again. For what it’s worth, I am hoping this does not recur for you.

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I had my appointment at the retina center today. Fairly uneventful, since they can’t do much until the blood clears and they can get better pictures inside the troubled eyes.

He basically assured me that there was no immediate cause of the bleed. That it wasn’t likely related to my current health, change in meds, or anything else. We knew 2 years ago that I had some retinopathy and I wasn’t able to get it lasered because they couldn’t adjust their schedule to accommodate my long-distance drive any. He said I’ve essentially been a ticking time bomb this whole time and was astounded I hadn’t had any vision issues sooner.

Basically the plan is to go back in 3 weeks, hoping the blood is dissipated enough to photograph that eye. If it is, they can make a better plan how exactly to proceed. He would like to do an Avastin (he prefers it to Eyelea, even though it’s an off-label use of a cancer drug) injection in the poor eye, but can’t until he can better see a patch of blood vessels that might be pulling on the retina. If he’s unable to inject the Avastin in that eye, he’s going to do it in the better eye instead… Because he thinks the biggest problem is the risk that the left eye also springs a leak at the same time. The Avastin makes the blood vessels less leaky until they can do the lasering. Fun times.

Good luck with all this, Robyn! I have some eye issues, too, so I understand how a threat to your eyesight can make you feel. You’re addressing it and now I hope things go your way.

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So sorry that you are having to deal with this Robyn.

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