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Hyphema

A Hyphema is an eye condition that refers to pooling or collection of blood inside the anterior chamber of the eye (between the cornea and the iris). The blood may cover the iris partially or totally including the pupil and thereby blocking the vision partly or completely. Trauma to the eye is the most common cause of Hyphema. Injury may take the form of blunt trauma, laceration trauma or abrasion.


Some of other conditions that cause Hyphema are:


  • Tumors in the eye
  • Abnormal blood vessels on the surface of the iris
  • Herpes virus(eye infection)
  • Intra-ocular lens problems (artificial lens implants)
  • Severe diabetes
  • Blood disorders such as sickle cell anemia

Signs and symptoms of the Hyphema vary according to the severity of the condition. Mild Hyphema may not even be visible to the naked eye or a tiny spot of blood may show up which normally gets absorbed on its own. As the condition progresses, the patient experiences the following symptoms.


  • Impaired vision
  • Eye pain, blurring or loss of vision
  • Bleeding in the anterior chamber of the eye
  • Light sensitivity or photophobia

Treatment

Vision and ocular pressure are checked and dilation is done to examine the fundus for retinal detachment or blood elsewhere in the eye. Visual acuity test and slit lamp test allow the eye doctor to check the internal structure of the eye for any other damage. The eye sockets and facial structures might need to be examined with a CT scan in case of severe trauma.

Mild cases of Hyphema heal on their own. When the bleeding is not severe, doctor may recommend certain guidelines to be practiced at home along with sedatives and pain relieving medications. These guidelines include covering the affected eye, elevating the head of the patient to help drain the fluid, bed rest and frequent monitoring of the eye condition. Avoid any medicines containing aspirin, arthritis and non-steroidal medication as it promotes bleeding.

Steroid eye drops are prescribed to control inflammation and pain. Severe cases of Hyphema require an aggressive approach. You can use an eye shield or protective eyewear to prevent the eye from any further injury. If elevated is noticed, blood is drained through surgical intervention to prevent glaucoma or cornea damage.


Bleeding in the Eye

Bleeding in the eyes is associated with many underlying conditions like hyphema, blood vessel damage (subconjuctival hemorrhage), diabetic retinopathy and vitreous hemorrhage.


The conditions for diabetic retinopathy occur because of long term diabetics. Prolonged high blood sugar levels can damage the blood vessels associated with the retina of the eye. These blood vessels become leaky or clogged. The leaky blood vessels initiate the process of hemorrhages which are visualized as spots of bleeding. In some instances the clogged blood vessels obstruct the supply of oxygen to the retina causing ischemic condition. Maintaining proper blood sugar levels along with controlled pressure is essential.

Subconjuctival hemorrhage occurs due to damage caused to the sclera or the white portion of the eye. The blood released because of the damaged blood vessel is trapped under the conjunctiva. Subconjuctival hemorrhage associated eye bleeding is often painless. It is mainly caused because of high blood pressure and also triggered by cough, vomiting and sneezing. The blood spots disappear gradually. Medical attention is required if symptoms such as blurred vision, pain and recurrent hemorrhages occur. The choice of medication given for subconjunctival hemorrhage are blood thinners like heparin and Coumadin.


Hyphema is caused due to injury to the eye. The trauma caused in the eye can be of blunt or closed types depending upon the intensity of the damage. Most of these traumas which result in the bleeding of the eye are because of external sources such sharp objects, industrial chemicals, fumes, injuries associated with boxing and martial arts. Smaller hyphemas are associated with bleeding and swelling of the eye and extreme hyphemas are associated with pain, bleeding, swelling and reddening of the entire eye. The diagnosis for hyphema is usually performed by an ophthalmologist evaluating the entire history of the case followed by series of visual acuity tests. A CT scan is also recommended if there is a suspicion of bone damage in the eye region caused because of trauma.


Vitreous hemorrhage is another predominant cause for eye bleeding. Other factors include tumors adjacent to the vitreous humor of the eye and macro aneurysms. The treatment options for vitreous hemorrhages include vitrectomy and through Krypton laser therapy.

Rare causes for bleeding in the eye

Apart from the common factors that are associated with the hemorrhages caused in the eye, some rare conditions such cancers and iritis also cause bleeding in the eyes. Cancers of the eye are usually diagnosed by biopsy and also by careful visual examination. Since the symptoms of the bleeding eye disease may mask the diagnosis of underlying cancer or tumor, malignancy is confirmed by pathologic determination. Iritis is caused because of the inflammation in the iris of the eye. It may be the result of a trauma caused to the eye or underlying systemic conditions such as sarcoidosis and tuberculosis. Analgesics are recommended for common iritis. Patients are advised to wear dark sunglasses.


Tonometry

Tonometry test is a diagnostic test to measure the intraoccular pressure (IOP). When the tonometry test measures the pressure inside the eye, it can help in detecting glaucoma. Ensure that you take off your contact lenses. Do not wear tight clothing around the neck as it can lead to increased pressure inside the eye. Do not smoke a few hours prior to the tonometry test. The tonometry test is also conducted in cases of head or eye surgery and hyphema.

When the pressure builds up within the eye due to improper drainage, it can cause permanent damage to the ooptic nerve. Tonometry is done as part of routine eye examination to check for glaucoma. Anesthetic eye drops are used to numb the eye before using the tonometer. In the application method of testing intraoccular pressure, a paper stained with Fluorescein is placed to the side of the eye thereby staining the front of the eye. The tonometer is then brought close to the cornea for testing. Here the intraoccular pressure is measured by the amount of weight that is needed to flatten the cornea. This type of tonometry test can also be conducted with a pencil-like instrument, which will give instant digital measurement. The air puff method of conducting tonometry is a non-contact one where a puff of air is blown at your eye and change in the light reflected from the cornea is measured to arrive at the intraoccular pressure. This method is preferred for children and persons who have undergone LASIK surgery.

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Collection of Pages - Last revised Date: October 19, 2017