Hyphema
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. 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.
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