What is a hyphema?

A hyphema occurs when there is accumulation of blood in the anterior chamber of the eye. The anterior chamber is the front section of the eye between the cornea (the clear window of the eye) and the iris (the colored portion of the eye). A hyphema is usually caused by trauma to the eye but can occur after surgery or, rarely, spontaneously in children with other medical problems. Redness on the white part of the eye is NOT a hyphema.

Symptoms of a hyphema

Patients with a hyphema have blurred or decreased vision. They may also have eye pain or be sensitive to light. Sometimes the accumulation of blood can be seen by the naked eye.

Treatment of a hyphema

Treatment of a hyphema involves waiting for the blood to clear, treating any increase in the eye pressure (called glaucoma) and trying to prevent additional bleeding. With a hyphema, there is a risk for additional bleeding inside the eyeball for the first several days after the injury. Limited activity or bed rest, often for several days to a week, is recommended to prevent additional bleeding. The patient should keep their head in an elevated position even during sleep and should wear a shield to protect the eye during this time. Steroid eye drops are often prescribed to decrease inflammation. Dilating drops may be used to reduce pain. 

Patients with hyphemas should not take any products containing aspirin or ibuprofen. Frequent visits to the ophthalmologist may be required to monitor for increased eye pressure, to make sure the vision is improving, and that the blood is clearing.

If the blood does not clear after a suitable period of time or if there is an uncontrollable rise in pressure inside the eye, surgery may be necessary to remove the blood from the eye.

After the hyphema heals, the doctor will discuss follow-up and symptoms to watch for in the future.