Hyphema
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| Hyphema Classification and external resources |
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| Hyphema - occupying half of anterior chamber of eye | ||
| ICD-10 | H21.0 | |
| ICD-9 | 364.41 | |
| DiseasesDB | 31299 | |
| MedlinePlus | 001021 | |
| eMedicine | oph/765 | |
| MeSH | C11.290.484 | |
Hyphema is blood in the front (anterior) chamber of the eye. It may appear as a reddish tinge, or it may appear as a small pool of blood at the bottom of the iris or in the cornea. Hyphemas are frequently caused by injury (blunt trauma) and may partially or completely block vision. Hyphemas may resolve by themselves, they may require medical treatment, or they may result in permanent visual impairment.
A long-standing hyphema may result in hemosiderosis and heterochromia.[1] Blood accumulation may also cause an elevation of the intraocular pressure.
First Aid for Hyphema (blood in the anterior chamber of the eye) includes bed rest with head elevated by 45-60 degrees with both eyes closed (not patched or bandaged), application of ice-pack, avoidance of straining during bowel movements and while bending over, and during any sexual activity. Medication to reduce eye-pressure and corticosteriods, both as eye-drops, should be started. No aspirin or NSAIDs. If pain is severe use Paracetamol.
[edit] See also
Hyphema
Overview
Hyphema is a term used to describe bleeding in the anterior chamber (the space between the cornea and the iris) of the eye. It occurs when blood vessels in the iris bleed and leak into the clear aqueous fluid. Hyphemas are usually characterized by pooling of blood in the anterior chamber that may be visible to the naked eye. The red blood cells of very small hyphemas are visible only with magnification. Even the slightest amount of blood in the anterior chamber will cause decreased vision when mixed in the clear aqueous fluid.
Bleeding in the anterior chamber is most often caused by blunt trauma to the eye. It may also be associated with surgical procedures. Other causes include abnormal vessel growth in the eye and certain ocular tumors.
Signs and Symptoms
Decreased vision (Depending on the amount of blood in the eye, vision may be reduced to only hand movements and light perception only)
Pool of blood in the anterior chamber
Elevated intraocular pressure (in some cases)
Detection and Diagnosis
It is very important for the doctor to determine the cause of the hyphema. If the hyphema is related to an ocular injury, any detail regarding the nature of the trauma is helpful. The doctor will assess visual acuity, measure intraocular pressure, and examine the eye with a slit lamp microscope and ophthalmoscope.
Treatment
The treatment is dependent on the cause and severity of the hyphema. Frequently, the blood is reabsorbed over a period of days to weeks. During this time, the doctor will carefully monitor the intraocular pressure for signs of the blood preventing normal flow of the aqueous through the eye's angle structures. If the eye pressure becomes elevated, eye drops may be prescribed to control it. The pupils are also evaluated to rule out damage to the iris.
In some cases, a procedure is performed to irrigate the blood from the anterior chamber to prevent secondary complications such as glaucoma and blood stains on the cornea.
Patients with significant hyphemas must rest and avoid strenuous activity to allow the blood to reabsorb.
[edit] External links
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