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Hyphema

Hyphema is a topic covered in the 5-Minute Clinical Consult.

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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 leading 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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Citation

Stephens, Mark B., et al., editors. "Hyphema." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816815/all/Hyphema.
Hyphema. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816815/all/Hyphema. Accessed April 18, 2019.
Hyphema. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816815/all/Hyphema
Hyphema [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 18]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816815/all/Hyphema.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Hyphema ID - 816815 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816815/all/Hyphema PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -