5-Minute Emergency Consult
Hyphema
Hyphema is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Blood in anterior chamber (AC) of the eye (between iris and cornea)
- Hyphema: Grossly visible layering of blood
- Microhyphema: Suspended RBCs visible by slit lamp only
- Genetics:
- Genetic predisposition is related to hereditary blood dyscrasias (see below)
Etiology
Etiology
- Blunt trauma: Most common (70–80%)
- Anteroposterior compression of the globe with simultaneous equatorial globe expansion causing rupture of iris stromal/ciliary body vessels
- Penetrating trauma: Direct injury to stromal vessels or sudden ocular decompression
- Spontaneous: Less common, lower incidence of complications:
- Tumors:
- Melanoma
- Retinoblastoma
- Xanthogranuloma
- Metastatic tumors
- Blood dyscrasias:
- Hemophilia
- Leukemia
- Thrombocytopenia
- von Willebrand disease
- Blood thinners: Aspirin, Coumadin, heparin, Pradaxa
- Neovascularization of iris: In proliferative diabetic retinopathy, retinal vein occlusion, retinal artery occlusion, carotid stenosis
- Postsurgical: Cataract extraction, trabeculectomy, pars plana vitrectomy
- Tumors:
ALERT
In children with no clear history of trauma, suspect child abuse
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Basics
Description
Description
- Blood in anterior chamber (AC) of the eye (between iris and cornea)
- Hyphema: Grossly visible layering of blood
- Microhyphema: Suspended RBCs visible by slit lamp only
- Genetics:
- Genetic predisposition is related to hereditary blood dyscrasias (see below)
Etiology
Etiology
- Blunt trauma: Most common (70–80%)
- Anteroposterior compression of the globe with simultaneous equatorial globe expansion causing rupture of iris stromal/ciliary body vessels
- Penetrating trauma: Direct injury to stromal vessels or sudden ocular decompression
- Spontaneous: Less common, lower incidence of complications:
- Tumors:
- Melanoma
- Retinoblastoma
- Xanthogranuloma
- Metastatic tumors
- Blood dyscrasias:
- Hemophilia
- Leukemia
- Thrombocytopenia
- von Willebrand disease
- Blood thinners: Aspirin, Coumadin, heparin, Pradaxa
- Neovascularization of iris: In proliferative diabetic retinopathy, retinal vein occlusion, retinal artery occlusion, carotid stenosis
- Postsurgical: Cataract extraction, trabeculectomy, pars plana vitrectomy
- Tumors:
ALERT
In children with no clear history of trauma, suspect child abuse
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Citation
Schaider, Jeffrey J., et al., editors. "Hyphema." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307355/all/Hyphema.
Hyphema. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307355/all/Hyphema. Accessed March 27, 2023.
Hyphema. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307355/all/Hyphema
Hyphema [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 March 27]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307355/all/Hyphema.
* Article titles in AMA citation format should be in sentence-case
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ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
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PB - Lippincott Williams & Wilkins
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DB - Emergency Central
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