Hyphema is blood in the front area (anterior chamber) of the eye. The blood collects behind the cornea and in front of the iris.
Causes, incidence, and risk factors
Hyphema is usually caused by trauma to the eye. Other causes of bleeding in the front chamber of the eye include:
- Blood vessel abnormality
- Cancer of the eye
- Severe inflammation of the iris
- Advanced diabetes
- Blood disorders such as sickle cell anemia
You may not be able to see a small hyphema when looking at your eye in the mirror. With a total hyphema, the collection of blood will block the view of the iris and pupil.
Signs and tests
Treatment may not be needed in mild cases. The blood is absorbed in a few days.
If bleeding comes back (usually in 3 - 5 days), the likely outcome of the condition will be much worse. The health care provider may recommend the following to cut down the chance that there will be more bleeding:
- Bed rest
- Eye patching
- Sedating medicines
You may need to use eye drops to decrease the inflammation or lower the pressure in your eye.
The eye doctor may need to remove the blood, especially if pressure in the eye is very high the blood is slow to absorb again. You may need to stay in a hospital.
The outcome depends upon the amount of injury to the eye. Patients with sickle cell disease are more likely to have eye complications and must be watched closely. People with diabetes will probably need laser treatment for the problem.
Severe vision loss can occur.
- Acute glaucoma
- Impaired vision
- Recurring bleeding
Calling your health care provider
Call your health care provider if you notice blood in the front of the eye or if you have an eye injury. You will to be examined and treated by an eye doctor right away, especially if you have decreased vision.
Many eye injuries can be prevented by wearing safety goggles or other protective eye wear. Always wear eye protection while playing sports such as racquetball, or contact sports such as basketball.
Crouch Jr ER, Crouch ER, Trauma: Ruptures and Bleeding. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 2012 ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2012:vol 4; chap 61.
Fudemberg SJ, Myers JS, Katz LJ, Spaeth GL. Glaucoma Following Trauma. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 2012 ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2012:vol 3; chap 54C.
Tingey DP, Shingleton BJ. Glaucoma associated with ocular trauma. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 10.17.
Last reviewed 11/20/2012 by Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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