Global Current Practice Patterns for the Management of Hyphema (original) (raw)
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Outpatient management of traumatic hyphema in children: Prospective evaluation
Journal of American Association for Pediatric Ophthalmology and Strabismus, 2004
Purpose: To evaluate the clinical outcome of children with traumatic hyphema treated on an outpatient basis. Methods: A prospective cases series. Thirty-five children with traumatic hyphema were treated as outpatients for the ocular injury from February 2002 to February 2003. Data regarding initial and final visual acuity, slit-lamp biomicroscopy, hyphema size,ophthalmoscopy, intraocular pressure, rebleeding, clearance time, and medical and surgical intervention were recorded. Results: Thirty (85.7%) children were male, and the major cause of traumatic hyphema was domestic tools (14 cases, 40.0%). Twenty-four patients (68.6%) presented low grades of hyphema. Seventeen patients (48.6%) had intraocular pressures higher than 24 mm Hg. The most common lesions associated with traumatic hyphema were corneal injuries (16 cases, 45.7%). The median final visual acuity was 20/25. Unsatisfactory final visual acuity (worse than 20/30) was statistically associated with ocular posterior segment lesions (P ϭ 0.009) and grade of hyphema (P ϭ 0.004). The grade of hyphema was also related to intraocular hypertension (P ϭ 0.018) and time for hemorrhage absorption (P Ͻ 0.001). Nine patients (25.7%) underwent surgical intervention. Rebleeding occurred in three patients (8.6%). Conclusions: Outpatient management is a feasible option for children with hyphema. Associated posterior ocular segment injuries and hyphema of greater magnitude were related to the worst final visual acuities. (J AAPOS 2004;8:357-361) FIG 3. Distribution of patients with normal or high intraocular pressure according to the hyphema grade.
Comparison between Microscopic and Macroscopic Traumatic Hyphema due to Blunt Ocular Trauma
2013
Purpose: This study was performed to compare complications and clinical course of microscopic and macroscopic hyphema resulting from blunt ocular trauma Methods: In a prospective observational case series during the period 21 March 2010 to 20 March 2011 all referred patient with traumatic hyphema to ophthalmic emergency ward of Ahvaz, main city of southwest of IRAN that met inclusion criteria were included in the study and followed for at least one year. Results: Of 197 patients with traumatic hyphema 37 patients were excluded by exclusion criteria. 160 patients who completed examinations and follow-up protocol were enrolled in the study, 99 patients (61.9%) had microscopic and 61 patients (38.1%) had macroscopic hyphema. In microscopic group 89 patients were male and in macroscopic group 46 patients were female. Clearing the anterior chamber was longer in macroscopic type (p=0.0001). Intraocular pressure (IOP) was significantly higher in macroscopic hyphema (p=0.007). Four (6/5%) c...
Demographic and etiologic characteristics of children with traumatic serious hyphema
Turkish Journal of Trauma and Emergency Surgery, 2013
We aimed to evaluate the etiologic factors, complications, follow-up, and treatment outcomes in serious hyphema following blunt ocular trauma in childhood. METHODS The medical records of 136 patients diagnosed as grade 3 or 4 hyphema due to blunt ocular trauma between January 2006 and December 2011 were evaluated. Visual acuity (VA), complications, and medical and surgical treatments were analyzed. Factors affecting visual prognosis were compared in grade 3 and 4 hyphema cases. RESULTS The mean age of patients was 9.7±4 years. Etiologic factors for trauma were stone in 53 (39%), bead bullet in 25 (18.4%) and others in 58 (42.6%) patients. The most common complication of grade 3 and 4 hyphema was traumatic mydriasis (19.1%), followed by cataract (9.6%) and glaucoma (5.1%). Medical treatment was successful in 114 (83.8%) patients, and 22 (16.2%) patients underwent surgery. Mean initial and final VA of grade 4 patients were found to be significantly lower than those of grade 3 patients. CONCLUSION In grade 3 and 4 hyphema due to blunt trauma, visual prognosis worsened in the presence of additional ocular pathologies. Considering the bad visual prognosis of severe hyphema patients, prompt treatment and close follow-up may prevent complications resulting in poor VA.
Purpose-To study the causes, associated ocular findings and visual acuity on presentation, complications and visual outcome following treatment in patients of hyphema due to blunt injury. Materials and Methods-A retrospective study was performed in 100 patients with hyphema due to blunt injury admitted in Maharani Laxmi Bai Medical College, Jhansi between August 2019 to January 2020. The gender, age, race, cause of blunt injury resulting in hyphema, eye involved, vision at admission, other associated ophthalmological findings, complications and visual outcome were noted from the case records of patients. The data were analyzed using SPSS programme. Results: Males were more predominantly affected (80%). Two-thirds of patients were aged below 30 years. Sports related injury (40%) was the most common cause for hyphema. Hyphema disappeared within 5 days in 65% of patients. Iris injuries were very commonly associated in the form of mydriasis, iridodialysis. The best corrected vision of 6/18 or better was noted in 75% of patients at the last follow-up. The follow-up of these subjects was very poor and thus the incidence of secondary glaucoma could not be established. Moderate blood staining of cornea occurred in 0.8% of patients. Conclusion: Sports related injury is the most common cause of hyphema in Jhansi. Good visual recovery, without serious complications, is possible with appropriate and in-time treatment in hyphema patients due to blunt injury.
International Medical Case Reports Journal, 2018
Corneal bloodstaining, which is brown or dark yellow in color, is induced by hemoglobin deposition, and its breakdown products extend into the corneal stroma. In this article, we report a rare case of corneal bloodstaining induced by total hyphema after rebleeding for traumatic hyphema. The patient underwent irrigation of the anterior chamber (AC) and cataract surgery of the right eye after trauma. After oral and topical treatment the imprint of corneal bloodstaining faded, and it nearly disappeared after the procedures. Corneal bloodstaining is undoubtedly a vision-threatening complication of total hyphema after ocular trauma, surgical intervention, and even rebleeding. Removal of the total hyphema as soon as possible decreases the severity of corneal bloodstaining, shortens the course of spontaneous healing, and thus improves vision.
https://www.ijhsr.org/IJHSR\_Vol.12\_Issue.10\_Oct2022/IJHSR-Abstract24.html, 2022
Background/Aim: Children and young adults are frequently affected by traumatic eye injuries resulting in hyphema. The aim of this study was to determine the incidence, complications and visual implication of traumatic hyphema among children in SouthEast Nigeria. Materials and Methods: A ten years retrospective study conducted in two mission hospitals located in two urban cities in Anambra state, Nigeria. Needed information which included sociodemographics and clinical findings among others, was extracted from the case files of children who had eye trauma within the period under review and entered into a proforma designed for the study. The information was analyzed using statistical package for social science, version 20(SPSS-20). Associations/correlations were tested using Pearson correlation and p ≤ 0.05 was accepted as statistically significant. Results: Thirty nine out of 211 children with eye trauma had hyphema. This gave a ten-year cumulative incidence of 18.5%. Traumatic hyphema was commoner in males than in females; male:female = 1.8:1. The age range of the children with traumatic hyphema was 4-17 years (mean=1 0.1 ± 3.7 years). Playing was the commonest activity at time of injury and stick, cane and stone were the commonest objects of injury. Early presentation was associated with lesser complications and better visual prognosis. Higher grades of hyphema were associated with higher rates of complications. There was no significant association between sickle cell trait/disease and hyphema grade or complications Conclusion: There is high incidence of hyphema among children with ocular trauma. Early presentation to hospital and appropriate prompt treatment is important in preventing possible sightthreatening complications.
Hyphema due to blunt injury: a review of 118 patients
International journal of ophthalmology, 2010
To determine the causes, associated ocular findings and visual acuity on presentation, complications and visual outcome following treatment in patients of hyphema due to blunt injury A retrospective study was performed in 118 patients with hyphema due to blunt injury admitted in University of Malaya Medical Centre, Kuala Lumpur, Malaysia. The gender, age, race, cause of blunt injury resulting in hyphema, eye involved, vision at admission, other associated ophthalmological findings, complications and visual outcome were noted from the case records of patients. The data were analyzed using SPSS programme. Males were more predominantly affected (93.2%). Two-thirds of patients (67.8%) were aged below 30 years. Sports related injury (38.1%) was the most common cause for hyphema. Hyphema disappeared within 5 days in 66.9% of patients. Iris injuries were very commonly associated in the form of mydriasis, sphincter tear and iridodialysis. Associated vitreous haemorrhage was noted in 11.9% o...
Hyphema. Part II. Diagnosis and Treatment
Compendium on Continuing Education For the Practicing Veterinarian, 2000
The clinical appearance of hyphema is variable and is influenced by the volume of blood and the amount of time erythrocytes are present in the anterior chamber. When hyphema is evident, a complete history should be obtained and a thorough physical examination performed to direct the initial selection of diagnostic tests. Secondary complications of hyphema include glaucoma, synechiae, cataract formation, blood-staining of the cornea, and blindness. Frequent measurement of intraocular pressure is recommended. The two primary management issues in animals with hyphema are prevention of secondary hemorrhage (by treating the underlying disease) and control of secondary glaucoma. Disciplines Eye Diseases | Medicine and Health Sciences | Ophthalmology | Veterinary Medicine Comments Dr. Komáromy was affiliated with the University of Pennsylvania from 2003-2012.
Hyphema. Part I. Pathophysiologic Considerations
Compendium on Continuing Education For the Practicing Veterinarian, 1999
Hemorrhage in the anterior chamber of the eye, or hyphema, results from a breakdown of the blood-ocular barrier (BOB) and is frequently associated with inflammation of the iris, ciliary body, or retina. Hyphema can also occur by retrograde blood flow into the anterior chamber via the aqueous humor drainage pathways without BOB breakdown. Hyphema attributable to blunt or perforating ocular trauma is more common than that resulting from endogenous causes. When trauma has been eliminated as a possible cause, it is prudent to assume that every animal with hyphema has a serious systemic disease until proven otherwise.