Equis ISSN 2398-2977

Anterior chamber: hyphema

Contributor(s): Dennis E Brooks, Graham Munroe

Introduction

  • Hemorrhage into the anterior chamber from the uvea.
  • Causes: anterior uveitis, blunt/penetrating ocular trauma, intraocular neoplasia, acute immunologic crisis, spontaneous.
  • Signs: depend upon individual cause - hemorrhage into anterior chamber.
  • Diagnosis: full ophthalmologic examination, ultrasonography, immune function tests.
  • Treatment: depends upon individual cause: rest; urokinase irrigation.
  • Prognosis: guarded to poor.

Pathogenesis

Etiology

  • Anterior uveitis   Uveitis: anterior - overview  : particularly a problem in chronic recurrent forms where neovascularization of the iris can   →   recurrent hemorrhage. The clotted blood often takes on a layering appearance with darker older blood ventrally.
  • Trauma: penetrating and non-penetrating injury to the eye can   →   transient or persistent hyphema.
  • Intraocular neoplasia, especially lymphosarcoma and medulloepithelioma.
  • Acute immunological crisis, eg monoclonal gammopathies, malignant myeloma, immune deficiencies   Immunology: combined immunodeficiency  and immune-mediated thrombocytopenia   Blood: thrombocytopenia  .
  • Spontaneous hyphema in apparently normal eyes.

Pathophysiology

  • Hemorrhage into anterior chamber, which usually arises from the uvea, due to a number of causes.

Timecourse

  • Unclotted hemorrhage will often disappear within 2-3 days if its cause is eliminated.
  • Clotted blood may require 2-3 weeks to resolve.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers


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