Intraocular hemorrhage in a patient with hemophilia

A 24-year-old man with severe classic hemophilia (factor VIII level less than 1%) had blunt trauma to his left eye that produced total hyphema with elevated intraocular pressure. Despite attaining sufficient hemostasis with factor VIII replacement, the anterior chamber remained completely filled with blood, which led to corneal blood-staining. Total hyphema was removed under management of replacement treatment. This consisted of sufficient cryoprecipitates to increase the calculated factor VIII level to 100%. For the 7-day post-operative period, the factor VIII level was above 15%. His surgical and post-operative course was uneventful. Blood-staining of the cornea was gradually reduced. Five months after surgery, he spontaneously had moderate hyphema with elevation of intraocular pressure. The blood in the anterior chamber was absorbed with replacement therapy. Though the visual acuity has improved, the fundus cannot be observed due to the vitreous opacity.