Hyphema

Symptoms: blurry vision, photophobia, headache; most commonly after trauma, however spontaneous hyphema could be sign of blood disorder (leukemia, hemophilia, von Willebrand disease) or side effect from medication (aspirin, warfarin)

Diagnosis: Layering of RBC in the anterior chamber, the larger the hyphema the higher the risk for increased ocular pressure therefore consider measuring intraocular pressure as well

Grade 0 - IV

0: no layering, just RBC "microhyphema"

I: < 1/3 of anterior chamber

II: 1/3- 1/2 anterior chamber

III: 1/2 of anterior chamber

IV: total hyphema, "8 ball"

Treatment:

• Elevate Head of bed
• Place Eye Shield
• Topical Steroids to reduce inflammation & help with scaring
• Dilating Drops
• Drops to lower intraocular pressure
• Avoid aspirin & NSAIDs
• Need emergency Ophthalmology assessment

Discharge instructions: Patient will need bed rest and daily eye pressure checks