Traumatic hyphema

Abstract

Multiple modalities of treatment for traumatic hyphema have been advocated in the past. Therapy should be directed at reducing the risk of secondary hemorrhage and the potentially devastating complications of corneal blood staining and optic atrophy. Therapeutic regimens proven successful include: a patch and shield to the traumatized eye; daily visual acuity and slit-lamp biomicroscopy, including intraocular pressure, evaluation of corneal clarity, and size of hyphema; topical atropine; the systemic administration of aminocaproic acid; and topical and systemic antiglaucomatous medications with elevated intraocular pressure. Surgical intervention should generally be avoided in hyphemas of less than 50%. In larger hyphemas, there are definite indications for surgical intervention. Preferred surgical methods include: irrigation and aspiration, and hyphema evacuation by vitrectomy instrumentation.