Hyphema
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Basics
Description
- A grossly visible collection of blood in the anterior chamber of the eye
- Microhyphema refers to red blood cells in the anterior chamber which do not layer out and are not grossly visible.
- Traumatic hyphema is a common complication of blunt or penetrating trauma to the eye that can result in permanent vision loss.
Epidemiology
Incidence
Annual incidence of 20 cases per 100,000 population (1)
Prevalence
- Up to 70% occur in children with a peak incidence at 10 to 20 years of age.
- Males are affected 3 to 5 times more often than females (1).
Etiology and Pathophysiology
- Blunt trauma is the most common cause, and assault is the most common mechanism.
- Penetrating trauma
- Postoperatively following intraocular surgery
- Neoplasm (retinoblastoma or iris melanoma)
- Clotting disorders (von Willebrand disease or juvenile xanthogranuloma)
- Pathophysiology: Posterior displacement of tissue stretches the limbal vessels resulting in a tear and lead to bleeding; red blood cells obstruct outflow of aqueous humor and remain in the anterior chamber.
Risk Factors
- Trauma
- Congenital bleeding disorders (sickle cell trait or disease)
- Anticoagulation
- Intraocular surgery
Commonly Associated Conditions
Blood dyscrasias such as sickle cell disease
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- A grossly visible collection of blood in the anterior chamber of the eye
- Microhyphema refers to red blood cells in the anterior chamber which do not layer out and are not grossly visible.
- Traumatic hyphema is a common complication of blunt or penetrating trauma to the eye that can result in permanent vision loss.
Epidemiology
Incidence
Annual incidence of 20 cases per 100,000 population (1)
Prevalence
- Up to 70% occur in children with a peak incidence at 10 to 20 years of age.
- Males are affected 3 to 5 times more often than females (1).
Etiology and Pathophysiology
- Blunt trauma is the most common cause, and assault is the most common mechanism.
- Penetrating trauma
- Postoperatively following intraocular surgery
- Neoplasm (retinoblastoma or iris melanoma)
- Clotting disorders (von Willebrand disease or juvenile xanthogranuloma)
- Pathophysiology: Posterior displacement of tissue stretches the limbal vessels resulting in a tear and lead to bleeding; red blood cells obstruct outflow of aqueous humor and remain in the anterior chamber.
Risk Factors
- Trauma
- Congenital bleeding disorders (sickle cell trait or disease)
- Anticoagulation
- Intraocular surgery
Commonly Associated Conditions
Blood dyscrasias such as sickle cell disease
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