Traumatic hyphema

Background

Rebleeding and elevated intraocular pressure = main concern.

Work-Up

Slit lampCheck pressureConsider CT ==DDx==

Ruptured globeRetinal detachmentRebleeding ==Treatment==

1) Restricted activity!2) eye shield3) elevation of the head to 30º4) pharmacologic control of pain and emesis5) teatment any underlying coagulopathy ==Disposition==

Inpatient:

• other injuries requiring hospital care
• suspected child abuse
• bleeding dyscrasia
• sickle hemoglobinopathy
• intraocular hypertension on initial examination
• delayed presentation
• large hyphemas (>50% anterior chamber)

Prognosis

Grade Ant Chamber Nl Vision I <33% 90% II 33-50% 70% III >50% 50% IV 100% 50%

Source

Adapted from KajiQuestions