Hyphema Diagnosis: Understanding Causes, Symptoms & Evaluation

Hyphema refers to the presence of blood in the anterior chamber of the eye. This is one of most challenging problems in ophthalmology because even a small hyphema can signify a major trauma of the eye. A hyphema usually results from blunt trauma and a rapid rise in intraocular pressure.

Instructions

• 1

  Obtain a patient history, especially of recent eye injuries. The cause of a traumatic hyphema is usually a projectile that strikes the eye such as a pellet gun, ball or fist. Males are affected three times as often as females for this reason.

• 2

  Check for causes of spontaneous hyphemas. These may the result of neovascularizaion as in the case of diabetes mellitus, ocular neoplasms such as a retinoblastoma or other vascular anomalies like a xanthogranuloma.

• 3

  Categorize the hyphema. Grade 1 is a hyphema that occupies less than a third of the anterior chamber; Grade 2 fills up to half of the chamber; Grade 3 takes up less than the total chamber; and a Grade 4 hyphema occupies the entire anterior chamber of the eye.

• 4

  Measure the intraocular pressure. One third of patients with more than 22 mm of pressure will develop at least a minor hyphema at some point and higher pressures can cause total hyphemas. Patients with glaucoma are more likely to develop a hyphema.

• 5

  Check for corneal blood staining. This occurs primarily in cases of total hyphema where the intraocular pressure is elevated continually for at least six days and indicates a severely damaged endothelium.