Hyphema

Hyphema

(Blood in the Eye)

Definition

Hyphema is when blood collects between the clear dome of the eye (cornea) and the colored part of the eye (iris). This can lead to a buildup in pressure that may harm the eye.

Normal Anatomy of the Eye

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Causes

The bleeding is caused by a tear in the iris or nearby structures. The is often caused by trauma. It may also happen due to certain health problems. Sometimes the cause is not known.

Risk Factors

Hyphema caused by trauma is more common in males. Other things that may raise the risk of this problem from trauma are:

  • A motor vehicle accident
  • Playing sports that put the eyes at risk, such as racquetball
  • Using power tools without proper eye protection

Health problems that may raise the risk are:

  • Eye diseases, such as glaucoma or anterior uveitis
  • Eye infections
  • Complications from eye surgery
  • Blood disorders, such as leukemia, hemophilia, or thrombocytopenia
  • Medicines that make it harder for the blood to clot, such as aspirin or warfarin
  • Structural problems, such as the abnormal growth of blood vessels
  • Cancerous tumors (rare)

Symptoms

Blood will be visible in front of part or all of the colored part of the eye. Other problems may be:

  • Eyesight problems, such as blurry vision
  • Pain
  • Sensitivity to light
  • Nausea or vomiting

Diagnosis

You will be asked about your symptoms and health history. You will also be asked about any recent injury. A physical will be done. It will focus on your eye and surrounding structures.

Your blood clotting time may be tested. This can be done with blood tests.

Images may be taken of your eye and nearby structures. This can be done with a CT scan.

Treatment

The goal is to clear the blood from the eye. This may happen on its own or treatment may be needed. Choices are:

  • Monitoring the eye for changes in pressure
  • Treating any underlying health problems that may be causing the hyphema
  • Medicines to ease discomfort and swelling, such as acetaminophen, steroids, or pupil-dilating eye drops

Some people may need surgery to:

  • Open clogged drainage channels
  • Remove excess fluid or blood

Prevention

Hyphemia is usually caused by trauma. To lower the risk:

  • Wear eye protection when playing sports or doing work that may result in eye injury.
  • Avoid situations that may involve fighting.
  • Wear a seat belt when you are in a motor vehicle.

RESOURCES:

American Academy of Ophthalmology
http://www.aao.org
National Eye Institute
https://nei.nih.gov

CANADIAN RESOURCES:

Canadian Ophthalmological Society
http://www.cos-sco.ca

References:

Approach to eye trauma—emergency management. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/approach-to-eye-trauma-emergency-management. Accessed October 21, 2020.
Eye injuries. Kids Health—Nemours Foundation website. Available at
...(Click grey area to select URL)
Accessed October 21, 2020.
Hyphema—emergency management. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/hyphema-emergency-management. Accessed October 26, 2020.
Romaniuk VM. Ocular trauma and other catastrophes. Emerg Med Clin North Am. 2013 May;31(2):399-411.
What is hyphema? American Academy of Ophthalmology website. Available at:
...(Click grey area to select URL)
Accessed October 26, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 5/19/2021

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