Traumatic hyphema: Clinical features and diagnosis

Authors
Christopher M Andreoli, MD
Matthew F Gardiner, MD
Section Editors
Richard G Bachur, MD
Jonathan Trobe, MD
Maria E Moreira, MD
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

Traumatic hyphema, or blood in the anterior chamber, is a common complication of blunt or

penetrating injury to the eye and can result in permanent vision loss. The goals of initial
assessment include recognition and characterization of the hyphema and identification of
associated orbital and ocular injuries. If ruptured globe is suspected, then emergent consultation
with an ophthalmologist is critical to ensure preservation of vision. In addition, optimal outcome
following a hyphema depends on early ophthalmologic intervention focused on prevention of
rebleeding and avoidance of intraocular hypertension. In most instances, patients recover with
vision intact. Vision loss is more likely in patients with large hyphemas, sickle
hemoglobinopathy or trait, or bleeding tendency.
This review covers the clinical features and diagnosis of traumatic hyphema. The management of
traumatic hyphemas is discussed separately. (See"Traumatic hyphema: Management".)

DEFINITION

●Hyphema refers to grossly visible blood in the anterior chamber of the eye (picture 1).
●Microhyphema describes dispersed red blood cells in the anterior chamber that do not
layer out to form a gross fluid level (figure 1).

EPIDEMIOLOGY

Incidence — The annual incidence of traumatic hyphema has been estimated at 12 injuries per
100,000 population, with males being affected three to five times more frequently than females
[1-4]. Up to 70 percent of traumatic hyphemas occur in children, with a peak incidence between
10 and 20 years of age [1,3,4].

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Literature review current through: Nov 2015. | This topic last updated: Jan 19, 2015.
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References
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1. Anonim. Traumatic hyphema. Diakses dari http://www.uptodate.com/contents/traumatic-

hyphema-epidemiology-anatomy-and-pathophysiology pada tanggal 2 Januari 2016 pukul 18.00.