Definition

What is hyphema?

A hyphema is a pooling or collection of blood inside the anterior chamber of the eye (the space between the cornea and the iris). The blood may cover most or all of the iris and the pupil, blocking vision partially or completely.

A hyphema is usually painful. If left untreated, it can cause permanent vision problems.

How common is hyphema?

Hyphema is not so common. It can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of hyphema?

The common symptoms of hyphema are:

  • Visible blood in the front of the eye
  • Sensitivity to light
  • Pain
  • Blurry, clouded, or blocked vision
  • Blood might not be visible if the hyphema is small

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you or your loved one has any signs or symptoms listed above or you have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Immediate medical attention is needed if hyphema occurs. Also, never take an eye injury lightly. Even if there is no bleeding, check in with your eye doctor.

Causes

What causes hyphema?

Blunt trauma to the eye is the usual cause of a hyphema. Additional bleeding may follow in the next 3-5 days even without additional trauma. This injury is usually blunt or closed trauma with typical causes, including athletic injury from a flying object, a stick, a ball, or another player’s elbow. Other causes include industrial accidents, falls, and fights.

A hyphema can also be caused by:

  • Abnormal blood vessels on the surface of the iris (colored part of the eye)
  • Eye infection caused by the herpes virus
  • Blood clotting problems such as hemophilia and sickle cell anemia
  • Intraocular lens problems (artificial lens implants)
  • Cancer of the eye

Risk factors

What increases my risk for hyphema?

A person is more likely to have a hyphema if:

  • He is an athlete
  • He is a small child
  • He is having special health conditions listed above

Please consult with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is hyphema diagnosed?

Your ophthalmologist asks about any history of eye injury, when the injury may have happened, and how it happened. It is important for your ophthalmologist to know if, for example, you were hit in the eye with a baseball or you ran into a low-hanging branch on a tree.

A complete eye examination is performed.

  • A visual acuity test checks for how well you can see. The intraocular pressure (pressure inside the eye) must be checked.
  • A special microscope, called a slit lamp, is used to look inside the structures of the eye.
    • A hyphema can be seen as a clot or layered blood in the anterior chamber of the eye. The condition called “eight ball” or “black hyphema” occurs when the entire anterior chamber is filled with blood. Smaller hyphemas may appear layered in the anterior chamber.
    • A microhyphema may also be seen. This appears as a haziness of suspended red blood cells in the anterior chamber.
  • If you have experienced severe trauma, the doctor may order a CT scan to look at the eye sockets themselves and other facial structures.
  • African-Americans and those of Mediterranean descent should be screened for sickle cell disease or thalassemia, which can lead to serious complications. In these cases, surgery may be considered an early option.

How is hyphema treated?

Hyphema should not be treated at home without seeing your ophthalmologist. Make no attempts to cover the eye, because, if done incorrectly, you may do more harm than good.

Treatment of hyphema depends on how readily you comply with instructions. Following directions for care is important. About 15-20% of people with a hyphema have further bleeding in 3-5 days. This is why compliance with care is so important.

Blood usually reabsorbs, but the doctor must make sure the process is resolving as expected. If intraocular pressure increases or if bleeding reoccurs, you may be hospitalized.

Your doctor will decide how to treat your hyphema based on a variety of factors, including:

  • Your age, overall health, and medical history
  • Extent of the injury
  • Your tolerance for specific medications
  • Personal opinion or preference

You will be instructed to do the following as part of home follow-up care:

  • Eye drops (steroid drops to limit inflammation and/or dilating drops to help with pain)
  • Patch over the affected eye
  • Bed rest
  • Limited eye movement (this means no reading)
  • Head elevated at least 40 degrees when sleeping (to help body absorb blood)
  • Check eye pressure daily
  • Pain can be managed with over-the-counter pain medication that does not contain aspirin. Aspirin should be avoided because it thins the blood, and that could increase bleeding.

Children and the elderly may not be able to follow the home treatment plan. They and others who have complications may be admitted to the hospital for close observation. Treatment is similar to that suggested for home follow-up care.

Medicine may be given to prevent you from vomiting; such activity that involves straining increases pressure in the eye.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage hyphema?

The following lifestyles and home remedies might help you cope with hyphema:

Hyphema can occur with any trauma to the eye. Wear protective eyewear whenever you play a sport that recommends it.

Every year, the patient should be checked for the development of glaucoma. Any significant eye trauma can damage the eye’s drainage system and put someone who has had a hyphema at risk for glaucoma.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 7, 2018 | Last Modified: March 7, 2018

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.