Causes, Grades, and Treatment for Hyphema of the Eye Due to Trauma and Accidents
A hyphema occurs when blood pools within the anterior chamber of the eye—usually due to some form of trauma to the globe—resulting in injury to the iris and leading to torn vessels. While they can also spontaneously arise given the presence of certain conditions, they are most commonly caused by trauma or ocular surgery.
History and Causes
In tracing the direct cause of hyphema, typically patients are asked if they have a history of anticoagulation therapies and/or bleeding diathesis, or any connections to genetic conditions, such as sickle cell disease or clotting disorders.
Specifically, diagnoses can include:
- Traumatic hyphema: where blunt trauma results in various injuries to intraocular structures, such as the iris, lens, retina, optic nerve, etc.
- Hyphema secondary to surgery: the risk of hyphema associated with intraocular surgery is higher in patients who have a particular ocular history and/or are predisposed to irregular vasculature.
- Neovascularization: occurs when there is abnormal blood vessel growth on the iris, ciliary body, etc. This most commonly occurs in diabetic patients with retinal microvascular disease.
- In conjunction with tumor growth: most frequently occurs when there has been ocular neoplastic disease, such as melanoma.
- Infectious or inflammatory: hyphemas, which result from common intraocular inflammatory conditions, such as herpetic uveitis.
- Resulting from a vascular anomaly: There are certain conditions, which can result in a hyphema; for example, diffuse iris nodules which can result in hyphema if they bleed spontaneously.
Hyphemas fall into the following grades:
- Grade 0: Red blood cells pooled within the anterior chamber, but there’s no visible layering;
- Grade I: Layered blood fills less than one-third of the anterior chamber;
- Grade II: Blood fills one-third to one-half of the anterior chamber;
- Grade III: Layered blood fills a minimum of one-half of the chamber, but less than the entire chamber;
- Grade IV: The anterior chamber is filled with either bright red blood (total hyphema) or dark red-black blood (known as “8-ball” or “blackball” hyphema), the later of which is more likely to lead to additional complications, such as papillary block.
When it comes to traumatic hyphemas, patients often complain of pain and headaches. Depending upon the specific circumstances involved, others can also suffer from blurred vision and ocular distortion.
Experienced Personal Injury Lawyers Who Care … At the Law Offices of Gerald Noonan, we are dedicated to serving clients in and around Massachusetts when they suffer from traumatic hyphemas due to someone else’s action (or inaction). These types of injuries can affect you for the rest of your life, leading to vision loss, headaches, and other complications. Contact us anytime for a free consultation—we are here to discuss your rights in a given case.
Hyphemas are notoriously difficult to treat, and close evaluation and follow-up is mandatory, as there is a high risk for rebleeding. Some patients need to be hospitalized, especially those with particular conditions, such as sickle cell disease, or those with bleeding diathesis, for example. For others, medical professionals typically manage via an eye shield, ensuring that activities are limited and the head is elevated at least 45 degrees.
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