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Hyphema: Blood in the Eye

From Troy Bedinghaus, O.D.,
Your Guide to Vision.
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About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD
Hyphema is a term used to describe bleeding in the anterior chamber of the eye, the space between the cornea and the iris. Hyphema occurs when blood leaks into the clear fluid of the aqueous humor. This pooling of blood is usually visible to the naked eye and causes decreased vision.
Causes:

Hyphema is usually caused by trauma to the eye. It may be the result of an injury from a flying object, a ball, a stick, an elbow to the eye, a fall or a fight. Hyphema may also be associated with surgical procedures. Other causes include abnormal vessel growth in the eye and certain ocular tumors.

Symptoms:
  • Blood in the eye. If the hyphema is large, the eye may look as if it is filled with blood. Smaller hyphemas are not visible to the naked eye.


  • Decreased vision. Depending on the amount of blood in the eye, vision may be reduced to hand movements and light detection only.


  • Elevated eye pressure. The pool of blood may increase the pressure in the eye, a symptom that must be controlled to prevent glaucoma.
Diagnosis:

It is very important for an eye doctor to determine the cause of hyphema. If the cause is the result of trauma to the eye, it is extremely important for the doctor to know the details of the injury. The eye doctor will test visual acuity, measure intraocular pressure, and examine the eye with a slit lamp microscope and ophthalmoscope.

Treatment:

Hyphema should not be treated without the help of an eye doctor. In mild cases of hyphema, the blood is usually reabsorbed by the body within a few days, as long as the patient follows the doctor's treatment instructions. Treatment usually consists of bed rest, eye patching, and sedation to minimize activity and reduce the chance of recurrent bleeding. If the intraocular pressure is increased, removal of the blood may be recommended, and hospitalization may be required.

Complications:

The following complications may result from hyphema:

  • Recurrent bleeding. The injury may bleed again, depending on the extent of the initial trauma. Rest is important in preventing further bleeding.


  • Glaucoma. An increase in the pressure inside of the eye is referred to as glaucoma. Increased pressure may cause blindness if left untreated.


  • Loss of vision. Hyphema should be treated as an emergency. Vision loss may occur without prompt treatment.


  • Damage to eye structures. Corneal blood staining sometimes results from hyphema, which may permanently cloud vision.
Prevention:

Hyphema can occur with any trauma to the eye. Wearing protective eyewear when playing sports is recommended to reduce the chance of injury to the eyes.

Updated: May 29, 2007
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