|
SIGNS
|
Blood in the anterior chamber | Possible corneal blood staining
|
|
WORK-UP
|
Thorough history | Slit lamp examination | Dilated fundus exam | Intraocular pressure measurement
|
|
Observation | Upright positioning | Strenuous activity is discouraged | Consider placing a metal shield over the eye | Consider discontinuing anticoagulants
|
|
Topical IOP-lowering medications may be indicated in the case of IOP spike (brimonidine 0.1% bid) | AVOID prostaglandins as they may increase inflammation
|
|
In rare cases, anterior chamber paracentesis may be considered
|
|
ADDITIONAL LAB | TESTS
|
Ultrasound biomicroscopy may be used to look for abnormalities or a foreign body, but extreme caution to be gentle is advised
|
|
ETIOLOGY
|
Trauma or surgery | Anticoagulant medications or sickle cell disease may be contributory | Vascular abnormalities (i.e. diabetes), neoplasms, and infectious processes that cause neovascularization may result in hyphemas
|
|
DIFFERENTIAL DX
|
Microhyphema | Neovascularization
|
|
NOTES
|
A 100% black hyphema is commonly referred to as an “8-ball” hyphema | Avoid gonioscopy unless necessary
|
