Hyphema (Bleeding in Eye)
Hyphema (Bleeding in Eye) Overview
Trauma to the eye can cause bleeding in the front (or anterior chamber) of the eye between the cornea and the iris. This “inside the eye” bleeding contained in the anterior chamber of the eye is called a hyphema.
The anterior chamber of the eye normally contains a clear liquid fluid called aqueous humor. The aqueous humor is secreted by the ciliary processes in the posterior chamber of the eye. The aqueous humor passes through the pupil into the anterior chamber.
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 person with a hyphema may have had a recent incident of eye trauma, might feel pain in the injured eye, and may have blurred vision.
If the hyphema is large, the eye itself may look as if it is filled with blood. Smaller hyphemas are not readily visible to the naked eye.
When to Seek Medical Care
Hyphema is a medical emergency. Call your ophthalmologist (a medical doctor who specializes in eye care and surgery) for an immediate appointment. If you cannot contact your ophthalmologist, go to a hospital's emergency department.
Questions to Ask the Doctor
- What is the size of the hyphema?
- Are there any signs of permanent damage to the eye?
- Are there any signs of permanent vision loss?
- How can I prevent this injury from happening again?
- When may I resume my regular activities?
Exams and Tests
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.