Hyphema

Definition

Hyphema is blood in the front area of the eye.

Causes, incidence, and risk factors

Hyphema is usually caused by trauma to the eye. Other causes of bleeding in the front chamber of the eye include:

• Blood vessel abnormality
• Cancer of the eye
• Severe inflammation of the iris

Symptoms

• Bleeding in the front portion of the eye
• Eye pain
• Light sensitivity
• Vision abnormalities

Signs and tests

• Eye examination
• Intraocular pressure measurement (tonometry)
• Ultrasound testing

Treatment

In some mild cases, no treatment is needed. The blood is absorbed in a few days.

The health care provider may recommend bed rest, eye patching, and sedation to reduce the likelihood of recurrent bleeding.

Eye drops to decrease the inflammation or lower the intraocular pressure may be used if needed.

The ophthalmologist may need to remove the blood, especially if the intraocular pressure is severely increased or the blood is slow to absorb again. You may need to stay in a hospital.

Expectations (prognosis)

The outcome depends upon the amount of injury to the eye. Patients with sickle cell disease are more likely to have eye complications and must be monitored more carefully.

Severe vision loss can occur.

Complications

• Acute glaucoma
• Impaired vision
• Recurring bleeding

Calling your health care provider

Call your health care provider if you notice blood in the front of the eye or you have a traumatic eye injury. You will need prompt diagnosis and treatment by an ophthalmologist.

Prevention

Many eye injuries can be prevented by wearing safety goggles or other protective eye wear. Always wear eye protection while playing sports such as racquetball, or contact sports such as basketball.

References

Brunette DD. Ophthalmology. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. Philadelphia, Pa: Mosby Elsevier; 2006: chap 70.