Hyphema

Key Features

• Nontraumatic causes include juvenile xanthogranuloma and blood dyscrasias

• Rarely, noted in the newborn after a stressful birth

Clinical Findings

• Blunt trauma severe enough to cause a hyphema may be associated with additional ocular injury, including iritis, lens subluxation, retinal edema or detachment, and glaucoma

• In patients with sickle cell anemia or trait, even moderate elevations of intraocular pressure may quickly lead to optic atrophy and permanent vision loss

Diagnosis

• Slit-lamp examination or penlight examination may reveal a layer of blood within the anterior chamber

• A hyphema may be microscopic or may fill the entire anterior chamber

Treatment

• A shield should be placed over the eye, the head elevated, and arrangements made for ophthalmologic referral