Hyphema (hemorrhage in the anterior chamber of the eye)
Last reviewed: 23.04.2024
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Hyphema (hemorrhage in the anterior chamber of the eye) is an eye injury that requires the immediate involvement of an ophthalmologist. Possible consequences include repeated bleeding, glaucoma and staining of the cornea, each of which can lead to persistent loss of vision.
[Symptoms of hyphema
Symptoms are associated with concomitant lesions, except when the size of the hyphema is sufficient to interfere with vision. Direct examination usually reveals the layering of blood, the presence of blood clots, or both in the anterior chamber of the eye. The stratification of blood looks like a meniscus-like level of blood in the lower part of the anterior chamber of the eye. Microcirculation is a less severe form, with direct examination it can be identified as a darkening in the anterior chamber of the eye or when viewed with a slit lamp - a suspension of red blood cells.
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Treatment of hyphemaemia
The patient is assigned a bed rest with a raised 30 "head, with a plate that protects the eye from additional trauma. Patients with a high risk of rebleeding (for example, with a large hemorrhage in the anterior chamber, hemorrhagic diathesis, receiving anticoagulants suffering from sickle cell anemia), with difficult to control increased intraocular pressure (IOP), even without complaints, can be hospitalized. NSAIDs for local and enteral use are contraindicated because they can contribute to Intraocular pressure may rise as acute (within an hour, usually in patients with sickle-cell anemia), and in months and years .In this regard, intraocular pressure is monitored daily for several days, then regularly following weeks and months , and when symptoms appear (for example, eye pain, visual acuity reduction, nausea - as with acute closed angle glaucoma) .If the pressure rises, a 0.5% solution of timolol is administered twice a day, 0.2% or 0.15% Brimonidine solution 2 times a day, according to separately or simultaneously. The result is assessed by the level of pressure that is monitored every hour or two, before the indicators are normalized or an acceptable reduction rate is reached; then it is usually measured 1-2 times a day. Assign also narrowing pupils of the drop (for example, 1% solution of atropine 3 times a day for 5 days) and topical glucocorticoids (for example, 1% solution of prednisolone 4-8 times a day for 2-3 weeks). Intravenous infusion of aminocaproic acid at a dose of 50-100 mg / kg (but not more than 30 g / day) every 4 hours can reduce the chance of rebleeding. A doctor without experience in ophthalmology should not apply dilating and narrowing drops in these cases. Rarely, with secondary bleeding with secondary glaucoma, surgical evacuation of the hematoma may be required.