Traumatic hyphema: Difference between revisions
| Line 5: | Line 5: | ||
*Can result in permanent vision loss | *Can result in permanent vision loss | ||
== | ==Diagnosis== | ||
*Blood in the anterior chamber | *Blood in the anterior chamber | ||
*Vision loss | *Vision loss | ||
*Eye pain | *Eye pain | ||
*Direct and consenual photophobia | *Direct and consenual photophobia | ||
==Work-Up== | ==Work-Up== | ||
Revision as of 20:33, 14 July 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
Diagnosis
- 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
| Grade | Ant Chamber Filling |
Nl Vision Prognosis |
| I | <33% | 90% |
| II | 33-50% | 70% |
| III | >50% | 50% |
| IV | 100% | 50% |
See Also
Source
UpToDate