Management of Traumatic Hyphema and Prevention of Its Complications

Abstract

Hyphema is defined as an accumulation of blood in the anterior chamber of the eye. Numerous conditions can lead to the development of hyphema, with blunt and penetrating trauma serving as the most common etiologies. Although the annual incidence of hyphema is relatively low, this condition must be recognized timely in order to manage and prevent its complications, such as glaucoma and corneal blood staining. This case report presents a 17-year-old adolescent who developed a hyphema complicated by a transient elevation in intraocular pressure following a high-speed motor vehicle accident. She responded to medical treatment and showed no signs of glaucomatous optic nerve damage at the end of her treatment course. The pathophysiology, clinical signs and symptoms, complications, medical and surgical treatments, and prognosis of hyphema are subsequently discussed.

Blunt Ocular Trauma in Sport

“…Initial treatment including bed rest, elevating the head of the bed, and the use of eye shields may be sufficient. Bed rest or activity restriction helps prevent the risk of rebleeding (15). If symptoms are worsening or you are unable to sufficiently monitor and/or treat, it is recommended to refer to an eye specialist who may recommend long-acting dilation drops and topical steroids.…”

“…Initial assessment should include evaluating for a ruptured globe. Patients should be seen daily during the first 5 to 7 d posthyphema (15,16). There is a 10% to 20% risk of rebleeding, which is typically seen within the first week (13).…”

Ophthalmologic Emergencies

“…Patients with traumatic hyphemas from blunt force trauma also require an orbital CT to evaluate for coexisting bony trauma and tonometry to assess IOP. Patients with hyphemas and increased IOP require emergent ophthalmology referral because they will require medical or possibly surgical treatment to reduce the risk of blindness (Chen & Fasiuddin, 2021). Until seen by ophthalmology, patients with hyphemas should rest with the head of the bed elevated to improve vision and help with resolution (Chen & Fasiuddin, 2021).…”

“…Patients with hyphemas and increased IOP require emergent ophthalmology referral because they will require medical or possibly surgical treatment to reduce the risk of blindness (Chen & Fasiuddin, 2021). Until seen by ophthalmology, patients with hyphemas should rest with the head of the bed elevated to improve vision and help with resolution (Chen & Fasiuddin, 2021). Steroids and cycloplegic medications are frequently used to improve comfort and reduce inflammation (Chen & Fasiuddin, 2021).…”

“…Until seen by ophthalmology, patients with hyphemas should rest with the head of the bed elevated to improve vision and help with resolution (Chen & Fasiuddin, 2021). Steroids and cycloplegic medications are frequently used to improve comfort and reduce inflammation (Chen & Fasiuddin, 2021).…”