Hyphema
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Basics
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
- 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
- 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
- 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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