From the Research
A hyphema is defined as an accumulation of blood in the anterior chamber of the eye, which can occur due to blunt or penetrating trauma, eye surgery, severe eye infections, or certain medical conditions. This condition can lead to complications such as glaucoma, corneal blood staining, and optic atrophy if not managed properly 1. The symptoms of hyphema include blurred vision, light sensitivity, and pain, and the severity can range from microscopic bleeding to complete filling of the anterior chamber with blood.
Causes and Risk Factors
The causes of hyphema can be categorized into traumatic and non-traumatic. Traumatic hyphema is the most common type, resulting from blunt or penetrating trauma to the eye. Non-traumatic hyphema can occur due to eye surgery, severe eye infections, or certain medical conditions such as diabetes, blood disorders, or tumors.
Diagnosis and Treatment
Diagnosis of hyphema is typically made through a slit-lamp examination, which allows for visualization of the anterior chamber and the presence of blood. Treatment usually involves rest, elevating the head while sleeping, avoiding physical activity, and using prescribed eye drops to reduce inflammation and prevent complications. In severe cases, surgery may be needed to remove the blood and prevent complications like increased eye pressure or permanent vision damage.
Management and Prevention of Complications
The management of traumatic hyphema involves the use of antifibrinolytic agents, such as aminocaproic acid or tranexamic acid, to reduce the risk of secondary hemorrhage 2. These agents have been shown to reduce the rate of recurrent hemorrhage, although the evidence is limited by the small number of events. The use of systemic or topical corticosteroids, cycloplegics, or non-drug interventions, such as binocular patching, bed rest, or head elevation, has not been shown to have a significant effect on the outcome of traumatic hyphema.
Recommendations
The use of antifibrinolytic agents, such as aminocaproic acid or tranexamic acid, is recommended to reduce the risk of secondary hemorrhage in patients with traumatic hyphema. Patients should avoid blood thinners like aspirin during recovery, as they can worsen bleeding. In severe cases, surgery may be necessary to remove the blood and prevent complications. It is essential to identify and treat associated ocular injuries, which often accompany traumatic hyphema, to prevent long-term vision damage.