Hyphema


EMERGENCY

Background

  1. Accumulation of blood in anterior chamber following an injury
  2. 25% have other associated eye injury

Pathophysiology

  1. Can indicate major damage to eye
  2. Injury results in:
  3. Limbal vessels are stretched
  4. Lens/ iris get displaced
  5. Tear occurs at iris or ciliary body
  6. Bleeding ensues
  7. Blood exits via canal of Schlemm
      • Can cause sudden increase in intraocular pressure
  8. Complications

Diagnostics

  1. History
  2. Symptoms
  3. Physical Exam

Acute Treatment

  1. General standard care
  2. Medications (cautious use)
  3. If increased intraocular pressure consider (stepwise Tx)
  4. Specific treatment
  5. Indications for surgical management

Disposition

  1. Consult ophthalmology
  2. Admission indications
  3. May be OK to D/C