Hyphema

Hyphema 

  • Accumulation of blood within the anterior chamber.
  • Frequently is the result of blunt eye trauma.
  • The source of bleeding is usually a tear in the anterior face of the ciliary body.

Clinical features:

  • Intraocular pressure elevation following eye injury as a result of mechanical obstruction of the trabecular meshwork by the clotted blood
  • Rarely, pupillary block from severe hyphema may occur, causing acute glaucoma.

Complications:

  • Prolonged unresolved hyphema
  • Persistent elevation of intraocular pressure complicated with optic nerve damage
  • Corneal blood staining and corneal endothelial decompensation.

Management:

  • Usually supportive after ruling out other possible coexisting medical problems such as coagulopathy or Sickle cell anemia.
  • Small hyphemas generally resolve in 4 to 5 days.
  • Systemic antifibrinolytic agents such as aminocaproic acid is reported to prevent secondary bleeding.
  • Topical or systemic glaucoma agents.
  • Surgical treatment to wash out the blood in cases with intractable intraocular pressure elevation, unresolved total hyphema, corneal blood staining and sickle cell patient.