Posture or Patching (PoP). Accelerated clearing of the media with massive vitreous hemorrhage and suspected retinal tear.

Rationale: About 30-40% of the cases of vitreous hemorrhage are, supposedly,
caused by posterior vitreous detachment (PVD) and retinal breaks. Diagnostics
are complicated because a sufficiently dense vitreous hemorrhage obstructs the
ophthalmologist's funduscopic inspection, and detection of a retinal tear by
ultrasonographic examination is not sufficiently reliable. Therefore, the
choice between instant vitrectomy, delayed vitrectomy or regular monitoring
remains erratic. If no (initial) signs of retinal tear or detachment are
observed, the patient is instructed to restrict physical activity and maintain
an upright position, and to return for periodic evaluation. This observational
policy may, however, lead to a delay of treatment and an increased risk of
developing retinal detachment which may result in a relatively poor outcome. It
is conjectured that binocular occlusion accelerates the clearing of an obscured
fundus.

Objective: To investigate whether binocular patching in combination with
posture adherence is superior to posture adherence alone in achieving
visualization of the superior fundus quadrants or not.

Study design: Randomized, open-label trial.

Intervention: Instruction to maintain posture (group 1 & 2) and binocular
patching (group 2).

Nature and extent of the burden and risks associated with participation,
benefit and group relatedness: Patients assigned to group 2 will be subjected
to regular treatment. They will neither benefit nor be exposed to any extra
risk. Patients assigned to group 1 may experience patching of their eyes for
upto 24 hours, although not involving any risk, as rather inconvenient. If the
probability of fundus visibility increases, and an accurate diagnosis is
established earlier, this would be beneficial.