Clinical features, management and visual outcomes on patients with traumatic hyphema in a reference ophthalmological clinic in Colombia

Abstract

Aim.To analyze clinical features, treatment, and results of patients with non-penetrating traumatic hyphema in an ophthalmological center in Colombia. Methods. A retrospective cohort study in which medical records of patients with traumatic hyphema were analyzed between 2013 and 2018. Results. 38 eyes of 37 patients (34 men, 3 women) were included. Average age was 30.6 ± 16.6 years. Sports-related (42.1%) and occupational accidents (34.2%) were the main causes. 67.5% of the eyes had grade I hyphema. 95% received topical corticosteroids, 92.1% topical mydriatics and 52.63% ocular hypotensive eyedrops. Two eyes with hyphema grade I did not receive steroids and resolved uneventfully. None of the eyes rebleeded, even without antifibrinolytics. One patient with grade IV hyphema required surgery. Mean hyphema's clearance time was 8.4 ± 3.2 days. The last mean corrected distance visual acuity was LogMAR 0.25. There were no complications directly related to the hyphema. Conclusions. Working related activities were the second cause of traumatic hyphema in our cohort, which might be attributable to poor awareness of the importance or ocular protection, or limited access to recommended protective devices. Outpatient management enabled adequate outcomes. Corticosteroids and mydriatics were the treatment cornerstone, though seemed not to be imperative when hyphema was grade I. We were not able to support the contributive role from antifibrinolytics, because none of our patients rebleeded in spite of the absence of them.

A retrospective study on risk factors for low vision in patients with traumatic hyphema

“…For patients with traumatic hyphema of grade or above, initial visual acuity less than 0.3, treatment time more than 24 hours, and complications of the posterior segment of the eye, we believe that hospitalization is very necessary, which can not only closely observe the changes of the condition, but also ensure timely drug or surgical treatment [13] . A retrospective study in Colombia showed that corticosteroids and mydriatics were effective in the treatment of traumatic hyphema above grade I [14] . However, in a meta-analysis published in 2023, researchers did not nd a signi cant improvement in visual acuity, and thought that patients treated with aminocaproic acid or tranexamic acid seemed to have less chance of rebleeding [5] .…”

Blunt Eye Trauma: Epidemiology, Prognostic Factors and Visual Outcome—A 10-Year Retrospective Study

“…The hyphema was classified into 5 subgroups. Grade 0: no visible layering, but erythrocyte within the anterior chamber (microhyphema); Grade I: layered blood occupying less than one-third of the anterior chamber; Grade II: blood filling one-third to one-half of the anterior chamber; Grade III: layered blood filling one-half to less than total of the anterior chamber; Grade IV: total filling of the anterior chamber with blood 2…”

Epidemiology and outcomes of hyphema: a single tertiary centre experience of 180 cases

“…Current strategies focus on prompt evaluation and treatment of complications, particularly rebleeding, but there are no clear indications regarding the duration and frequency of follow‐up, especially in uncomplicated cases. Furthermore, recent studies regarding hyphema have either focused on defined populations (such as children) or were performed internationally (Al Ali, Al Mass & Bener 2012; Soohoo et al 2013; Boese et al 2018; Miller et al 2019; Richards et al 2019; Galvis et al 2020). As such, most large‐scale studies performed in the United States are outdated (Coles 1968; Edwards & Layden 1973; Witteman et al 1985; Thomas, Parrish & Feuer 1986; Kennedy & Brubaker 1988; Spoor et al 1990) and do not reflect current preferred patterns of management.…”