Hyphema

• Accumulation of blood within the anterior chamber.
• Frequently is the result of blunt eye trauma.
• The source of bleeding is usually a tear in the anterior face of the ciliary body.

Clinical Features

• Intraocular pressure elevation following eye injury as a result of mechanical obstruction of the trabecular meshwork by the clotted blood
• Rarely, pupillary block from severe hyphema may occur, causing acute glaucoma.

Complications

• Prolonged unresolved hyphema
• Persistent elevation of intraocular pressure complicated with optic nerve damage
• Corneal blood staining and corneal endothelial decompensation.

Management

• Usually supportive after ruling out other possible coexisting medical problems such as coagulopathy or Sickle cell anemia.
• Small hyphemas generally resolve in 4 to 5 days.
• Systemic antifibrinolytic agents such as aminocaproic acid is reported to prevent secondary bleeding.
• Topical or systemic glaucoma agents.
• Surgical treatment to wash out the blood in cases with intractable intraocular pressure elevation, unresolved total hyphema, corneal blood staining and sickle cell patient.