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Trauma
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.

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