Traumatic hyphema: Difference between revisions
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==Prognosis== | |||
==Prognosis== | ==Prognosis== | ||
{| class="pbNotSortable" width="200" cellspacing="1" cellpadding="1" | |||
Grade Ant Chamber Filling Nl Vision Prognosis | | Grade | ||
I <33% 90% | | Ant Chamber Filling<br /> | ||
II 33-50% 70% | | Nl Vision Prognosis<br /> | ||
III >50% 50% | |- | ||
IV 100% 50% | | I | ||
| <33% | |||
| 90% | |||
|- | |||
| II | |||
| 33-50% | |||
| 70% | |||
|- | |||
| III | |||
| >50% | |||
| 50% | |||
|- | |||
| IV | |||
| 100% | |||
| 50% | |||
|} | |||
==Source== | ==Source== | ||
Revision as of 08:32, 12 March 2011
Background
- Typically casued by blunt trauma to the orbit
- Main concern = rebleeding and elevated intraocular pressure
- Worse around days 3-5
- Can result in permanent vision loss
Clinical Features
- Blood in the anterior chamber
- Vision loss
- Eye pain
- Direct and consenual photophobia
Work-Up
- Slit lamp
- Check pressure once globe rupture is excluded!
- Consider CT
==DDx==
- Ruptured globe
- Retinal detachment
- Rebleeding
==Treatment==
- Elevation of the head
- Eye shield
- Pharmacologic control of pain and emesis
- Bed rest
- No reading (accommodation may further stress injured blood vessels)
- Cycloplegic
- For comfort if globe rupture has been excluded
- Topical steroid
- Treat any underlying coagulopathy
==Disposition==
Inpatient:
- suspected child abuse
- bleeding dyscrasia
- sickle hemoglobinopathy
- intraocular hypertension on initial examination
- delayed presentation
- large hyphemas (>50% anterior chamber)
Prognosis
Prognosis
| Grade | Ant Chamber Filling |
Nl Vision Prognosis |
| I | <33% | 90% |
| II | 33-50% | 70% |
| III | >50% | 50% |
| IV | 100% | 50% |
Source
UpToDate