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Management of traumatic hyphema.

William Walton1, Stanley Von Hagen, Ruben Grigorian

  • 1Institute of Ophthalmology and Visual Science, New Jersey Medical School, Newark, New Jersey 01701-1709, USA.

Survey of Ophthalmology
|August 6, 2002
PubMed
Summary

This review focuses on managing traumatic hyphema (blood in the anterior chamber). Key recommendations include topical cycloplegics, corticosteroids, activity restriction, and avoiding NSAIDs, with surgery reserved for severe cases.

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Area of Science:

  • Ophthalmology
  • Trauma Care

Background:

  • Hyphema, or blood in the anterior chamber, can result from trauma, surgery, or various medical conditions.
  • Complications include elevated intraocular pressure, synechiae, optic atrophy, and vision impairment.
  • Secondary hemorrhage (rebleeding) occurs in 0-38% of traumatic hyphema cases, potentially worsening visual prognosis.

Purpose of the Study:

  • To review and recommend management strategies for hyphemas resulting from closed globe trauma.
  • To outline treatment considerations, including medications, activity levels, and surgical indications.

Main Methods:

  • Literature review of management issues for traumatic hyphema.
  • Formulation of evidence-based recommendations for clinical practice.

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Main Results:

  • Routine use of topical cycloplegics and corticosteroids is advised.
  • Systemic antifibrinolytic agents or corticosteroids, a rigid shield, and activity restriction are recommended.
  • Non-steroidal anti-inflammatory agents should be avoided.

Conclusions:

  • Outpatient management is suitable for compliant patients without high-risk factors.
  • Surgical intervention is indicated for corneal blood staining or uncontrolled intraocular pressure.
  • Prompt identification and treatment of associated ocular injuries are crucial.