User:Mr. Ibrahem/Hyphema

Hyphema is when blood enters the front (anterior) chamber of the eye, the area between the iris and the cornea. Symptoms often include blurry vision and pain with bright light. A layer of blood may be seen in the lower part of the eye when a person is standing. Complications may include glaucoma and permanent vision loss.

It most commonly occurs due to a direct injury to the eye; though may occasionally occur spontaneously. Common types of direct injury including getting hit by a ball in sports and assault. Risk factors include leukemia, hemophilia, von Willebrand disease, sickle cell disease, diabetes, and being on anticoagulant medication. The underlying mechanism involves bleeding from the ciliary body or iris. Diagnosis is based on examination, including by slit lamp.

Management involves raising the head of the bed more than 30 degrees, including during sleep, an eye shield, and close follow up by an ophthalmologist. Medication to manage pain and nausea may also be required. This may include cyclopentolate eye drops to prevent the pupil from moving, as long as the intraocular pressure is normal. Bleeding disorder may also require treatment. For those with high intraocular pressures or who are not improving, surgery may be recommended.

Most people, especially those with smaller bleeds, recover fully. In those with less than 33% involvement recovery is about 90%, while this decreases to about 50 to 75% when the entire anterior chamber is full of blood. Hyphema affects about 12 per 100,000 per year. Most cases (about 70%) occur in children. Males are affected more commonly than females.