Hyphema

Hyphema, or hemorrhage in the anterior chamber can result from trauma, uveitis, glaucoma, intraocular tumors, retinal detachments, and systemic diseases (hypertension, platelet/coagulation diseases, neoplasia, causes of uveitis, etc.) A thorough physical exam with blood pressure evaluation is essential and stabilization of more critical injuries/conditions should be a priority. Labwork, including a CBC/Chemistry, platelet count, clotting factors, and potentially specific infectious/immune tests should be performed. Evaluation of intraocular pressures by rebound/applanation tonometry is important. Initial treatment typically comprises topical and systemic steroidal or non-steroidal anti-inflammatories (depending on the patient’s health and physician preference) and systemic analgesia. Elevated intraocular pressures should be addressed. Systemic antimicrobials may be recommended if underlying bacterial disease is suspected or confirmed. Treatment of systemic hypertension is essential if it is present. Referral for specialist evaluation and treatment should be considered.