Hyphema

Definition
Hyphema is blood in the front chamber of the eye, usually caused by trauma to the eye.

Causes, incidence, and risk factors

Hyphema is usually caused by trauma to the eye, which may be a blunt or perforating injury. Severe inflammation of the iris, a blood vessel abnormality, or cancer of the eye may occasionally cause bleeding into the front chamber.

A layering of blood in front of the iris can be noticed when the person remains upright for a while. Acute glaucoma can occur suddenly in this condition.

Symptoms

     
  • Bleeding within the front portion of the eye, between the cornea and the lens, in the anterior chamber  
  • Eye pain  
  • Vision abnormalities  
  • Light sensitivity

Signs and tests

     
  • Eye examination  
  • Intraocular pressure measurement (tonometry)

Treatment

In some mild cases, no treatment is required, and the blood is absorbed within a few days. Bed rest, eye patching, and sedation to minimize activity and reduce the likelihood of recurrent bleeding are often prescribed. Eye drops to decrease the inflammation or lower the intraocular pressure may be used if needed.

Removal of the blood by an ophthalmologist may be necessary, especially if the intraocular pressure is severely increased or the blood is slow to resorb. Hospitalization may be required.

Expectations (prognosis)

The outcome depends upon the extent of injury to the eye. Patients with sickle cell disease have a greater likelihood of ocular complications and must be monitored more carefully. Severe vision loss can occur. Prompt diagnosis and treatment by an ophthalmologist is necessary.

Complications

     
  • Recurring bleeding  
  • Impaired vision through blood staining of the cornea  
  • Glaucoma

Calling your health care provider

Call your health care provider if blood is noticed in the front of the eye or if traumatic eye injury occurs.

Prevention

Many eye injuries can be prevented by wearing safety goggles or other protective eye wear. When participating in sports such as racketball, or contact sports such as basketball, it is a good idea to wear eye protection.

Johns Hopkins patient information

Last revised: December 3, 2012
by Levon Ter-Markosyan, D.M.D.

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