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Pediatric traumatic hyphema: a review of 138 consecutive cases
Jeffrey R SooHoo1, Brett W Davies, Rebecca S Braverman
1Department of Ophthalmology, University of Colorado Denver, Aurora, Colorado.
Insights
Pediatric traumatic hyphema, often occurring during home play, rarely leads to serious vision loss or rebleeding. Most cases resolve with conservative outpatient management, though elevated intraocular pressure may necessitate surgery.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Ocular Injury
Background:
- Traumatic hyphema in children is a significant ocular injury requiring careful management.
- Understanding the demographics and outcomes of pediatric traumatic hyphema is crucial for effective treatment strategies.
Purpose of the Study:
- To detail the patient demographics and clinical outcomes of children (<18 years) with traumatic hyphema.
- To analyze injury mechanisms, visual acuity, and intraocular pressure (IOP) in pediatric hyphema cases.
Main Methods:
- Retrospective review of 138 pediatric traumatic hyphema cases at a tertiary medical center (2003-2011).
- Data collected included age, sex, ethnicity, injury location, visual acuity, and intraocular pressure (IOP) at presentation and follow-up.
Main Results:
- 88% of cases occurred in boys; most injuries happened at home due to play, projectiles, or sports.
- Only 3 patients had visual acuity <20/40 at 1-month follow-up; no rebleeding events were reported.
- Elevated IOP was observed in 33 patients, with 4 (12%) requiring surgical intervention.
Conclusions:
- Home-based injuries are the most common cause of traumatic hyphema in children.
- Conservative outpatient management, including activity restriction and topical medications, is typically effective.
- Higher presenting intraocular pressure (IOP) is linked to the need for surgical intervention.
Purpose:
To report the demographics and outcomes in children (<18 years of age) who developed hyphema from ocular trauma and were subsequently cared for at a tertiary medical center.
Methods:
The medical records of consecutive patients seen at Children's Hospital Colorado diagnosed with traumatic hyphema between September 1, 2003, and December 31, 2011, were retrospectively reviewed. The following data were recorded: patient age, parent/guardian-reported ethnicity, sex, injury location, visual acuity, and intraocular pressure (IOP) at presentation and follow-up.
Results:
A total of 138 cases of unilateral hyphema were included, with 88% occurring in boys (mean age, 10.1 years; range, 1-19). Over 90% of injuries occurred in the home setting, with the most common mechanisms of injury being general play, projectiles from guns, and sports injuries occurring during games or practice. Only 3 patients had visual acuity <20/40 at 1 month's follow-up, and no patient experienced a rebleeding event. Most of the 33 patients with elevated IOP were managed medically; 4 (12%) required surgery.
Conclusions:
The majority of children with traumatic hyphema in this patient cohort were injured in the home setting. Very few patients underwent surgery for ocular hypertension, but higher IOP at presentation was associated with the need for surgical intervention. Outpatient care with activity restriction and topical medications usually led to resolution of hyphema without serious complications or visual loss.
