Hyphema | Treatment Options | Ophthalmology

Hyphema

What is hyphema?

Hyphema is the pooling or collection of blood within the anterior chamber of the eye (the space between the cornea and the iris). Blood covers most or all of the iris and pupil, partially or completely obstructing vision. Hyphema is usually painful. If left untreated, it can cause permanent vision problems. Hyphema is usually caused by an injury to the eye and is accompanied by increased intraocular pressure (pressure inside the eye). However, it can occur without warning in children with sickle cell anemia or other medical conditions such as hemophilia.

The lesions can cause bleeding in front of the eye (or anterior chamber), between the cornea and the iris. This bleeding is called hyphema. This part of your eye contains a clear liquid called aqueous humor. The folds behind the eye (or posterior chamber) called the ciliary process produce this fluid. Enter the previous room for your student. Hyphema requires immediate medical attention. Wearing eye protection while playing sports is the best way to prevent hypothermia. Also, never take eye injuries lightly. If it does not bleed, see your eye doctor.

What are other symptoms of hyphema?

In addition to the blood in the eye, the following symptoms usually are associated with hyphema:

  • Visible blood in the front of the eye
  • Sensitivity to light
  • Pain
  • Blurry, clouded, or blocked vision
  • Blood might not be visible if the hyphema is small
  • Blurry or distorted vision
  • Eye pain
  • Light sensitivity (photophobia)
  • Headache

Eye pain, sensitivity to light and headache are especially likely to occur if a hyphema is causing increased intraocular pressure (IOP).

Causes and risk factors of hyphema

70% of hyphemas occur in children, especially men 10-20 years of age. They are usually caused by blunt force injuries from such activities:

  • Sports
  • Industrial accidents
  • Waterfall
  • Fights
  • Shoot BB and Airsoft guns

Less common causes:

  • Eye surgery
  • Abnormal blood vessels in your iris
  • Herpes virus eye infection
  • Blood clotting problems
  • Eye cancer

Some things that affect your blood You may have hyperemia,

  • Leukemia
  • Hemophilia
  • Sickle-cell anaemia
  • Von Willebrand disease
  • Blood-thinning drugs (anticoagulants)

Diagnosis of hyphema

Your doctor will ask if you have ever had an eye injury and what happened before the hyphema. For example, it is important for them to know if you have been hit in the eye with a baseball or if you have run into a tree branch.

The doctor will do an eye exam. These include:

  • Visual acuity test to see how well you can see. They also control the pressure inside your eye (called intraocular pressure).
  • Look into your eye with a special microscope called a slit lamp. Hyphema looks like a clot or a layer of blood in front of the eye. If the anterior chamber is filled with blood, it is called a total, black, or eight-ball hyphema. Your doctor can also see if you have a microhyphema that looks like a fog of red blood cells.
  • CT scan to view the eye sockets and other parts of the face if the injury is severe
  • Screening for sickle cell anemia or thalassemia in people of African descent

Questions to ask your doctor

  • How great is hypothermia?
  • Are there signs of permanent damage?
  • Are there signs of permanent vision loss?
  • How can I prevent this injury from happening again?
  • Should I stop taking blood thinners?
  • When can I go back to my normal activities?

Treatment of hyphema

If your hyphema is mild, it will heal on its own in a week. You can treat any pain you experience with over-the-counter pain relievers that do not contain aspirin. Aspirin should be avoided because it binds to the blood and can increase bleeding. Your doctor will decide how to treat your hyphema based on a variety of factors:

  • Your age, general health, and medical history
  • The extent of the injury
  • Your patience for drug specifics
  • Opinion or personal preference

Once your doctor has collected this information, you will be able to choose from the following treatments:

  • Eye drops (steroid drops to limit inflammation and/or drops to help with pain)
  • Patch on the affected eye
  • Bed rest
  • Limited eye movement (i.e. not reading)
  • The head must be at least 40 degrees high during sleep (helps the body absorb blood)
  • Check eye pressure daily

Medical treatment

Between 15% and 20% of people with hyphema will bleed more in 3 to 5 days. Your body normally absorbs blood, but your doctor will definitely want it to happen. If the pressure in the eye increases or bleeds more, you may need to stay in the hospital.

It is important to follow your treatment plan. It usually includes:

  • Limit eye movement: Relax on the sofa with the head of the bed elevated as high as possible.
  • Use eye drops as directed: Your doctor will prescribe atropine to disperse (expand) your pupil and corticosteroids to prevent scarring.
  • Protect your eyes: Cover them with arm or to prevent further injury. You will need to wear a patch over the arm or to keep light away from your eye.
  • Take care of your medications: Do not take aspirin medications. It causes more bleeding. Also avoid nonsteroidal anti-inflammatory drugs like naproxen, ibuprofen, and many arthritis-like drugs. You can use a mild pain reliever like acetaminophen, but don’t take too much. You need to know if you have pain in your eyes. It may be related to increased stress. If the pain is severe, see a doctor immediately.
  • Manage your stress: Your doctor may want to measure the pressure inside your eye every day for several days.

You can also get medicine to prevent vomiting that increases the pressure inside your eye.

Red blood cells blocking the mesh inside your eye can sometimes increase stress. If your eye pressure rises, your doctor may prescribe a medicine called a beta-blocker. Children and the elderly may not be able to follow a home treatment plan. They and those with problems must stay in the hospital. Depending on your case and your other medical conditions, you may need surgery.

Possible complications of a hyphema

When a hyphema is present, there are certain complications that a person can experience. These may include:

  • Glaucoma: This condition is characterized by pressure in the eye increasing. If glaucoma is not treated, it can lead to blindness.
  • Eye structure damage: This condition can sometimes lead to corneal blood staining. In some cases, this can result in permanently cloudy vision.
  • Recurrent bleeding: It is possible for a hyphema to bleed again. This is more common with more severe cases.
  • Vision loss: It is important that a hyphema is viewed as an emergency and treated immediately. Without immediate treatment, vision loss is possible.
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