Table of ContentsView AllTable of ContentsHyphema SymptomsCausesDiagnosisTreatment

Table of ContentsView All

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Table of Contents

Hyphema Symptoms

Causes

Diagnosis

Treatment

Hyphema is the medical term for bleeding in the anterior chamber of the eye—the space between the cornea and theiris. Most often a hyphema is the result of aninjury such as a blow to the eye, although there are a number of diseases and conditions that can increase the risk of a spontaneous hyphema.

The pooling of blood is almost always visible to the naked eye and painful. It can interfere with vision and cause a dangerous increase in eye pressure, in which case a hyphema is considered a medical emergency that requires urgent medical attention to protect overall eye health and minimize the risk of permanent vision loss.

Depending on the severity of a hyphema, treatment can range from simple home care to surgery.

It’s rare that a hyphema will not produce obvious symptoms, although very minor ones may only be visible with an eye exam and won’t hurt. Most hyphemas are unmistakable, however, and present with several obvious symptoms:

Hyphemas are graded on a scale of 0 to 4 based on the amount of blood obscuring the cornea. The higher the grade, the more risk of intraocular pressure which can lead to glaucoma and vision loss.

Complications

The majority of people with hyphemas fully recover, but those with a high-grade hyphema are at increased risk of any of several serious complications:

People with sickle cell disease who develop a hyphema are at an increased risk of complications.

A hyphema typically results from trauma to the eye, but it can also develop spontaneously and is associated with certain underlying medical conditions.

Traumatic Hyphema

A traumatic hyphema is a blunt or penetrating injury that can happen as the result of being hit in the eye with an object such as a ball, stick, fist, or elbow. It can also occur from the impact of a fall. Children are especially at risk while playing certain sports, such as baseball, basketball, softball, and soccer.

A hyphema is also a potential complication of eye surgery and requires treatment similar to that for traumatic hyphema.

Approximately 70% of traumatic hyphemas occur in children, especially boys between the ages of 10 and 20 while participating in sports or other recreational activities.

Spontaneous Hyphema

Spontaneous hyphemas tend to occur in people with medical conditions that predispose them to blood or vascular problems:

It is important for an ophthalmologist to determine the cause of a hyphema. If there was trauma to the eye, they will need to know the details of the incident in order to first determine if the injury is an open globe injury—meaning something has penetrated or seriously injured the outer layers of the eye.

If it’s not a penetrating injury, thedoctorwill take a medical history and then examine the eye to determine if it is a hyphema or anothercause of redness, such as uveitis (which again can result in a hyphema),conjunctivitis(an eye infection commonly referred to as pinkeye), orsubconjunctival hemorrhage(broken blood vessels of the eye).

If a hyphema is suspected, the doctor will testvisual acuity, measure intraocular pressure, and examine the eye with aslit lamp microscopeand ophthalmoscope. In some cases, a computerized tomography (CT) scan may be necessary to fully examine internal eye structures.

Testing for sickle cell disease or other conditions that increase the risk of complications from a hyphema may also be done.

If an object penetrates your eye, donottry to remove it. Secure it in place if you can, and immediately go to your ophthalmologist or a hospital emergency department.

Hyphema is a medical emergency that should not be treated without the help of an eye doctor. If you detect even a tiny amount of bleeding in your eye, with or without pain, or you get hit in the eye and think there’s a chance you’ve been injured, see a doctor. The severity of a hyphema determines how it should be treated.

Home Self-Care

In mild cases of hyphema, the body usually reabsorbs the blood within a few days, as long as certain measures are taken. These typically include bed rest with the head elevated 30 degrees to 45 degrees and wearing an eye patch.In some cases daily monitoring of eye pressure is advisable.

Prescription Medication

Topical eye medications—such as cycloplegics which prevent movement of the iris, and topical or oral corticosteroids to reduce inflammation—are commonly prescribed.Sedatives may also be used to minimize activity and reduce the chance of recurrent bleeding. Tylenol (acetaminophen) with or without codeine may be prescribed for pain.

Aspirin or blood thinners should be avoided if you have a hyphema, so tell the doctor who treats you if you take these medications regularly. It may be necessary to discontinue them for a few days if the doctor who prescribed them feels it will be safe to do so.

Surgeries and Specialist-Driven Procedures

Your doctor will want to examine your eye after a few days to make sure the hyphema is improving. If not or if the intraocular pressure increases, surgical removal of the blood may be recommended and hospitalization may be required.

Surgeries and specialist-driven procedures which may be used include:

If you experience a hyphema, avoid strenuous activity for at least a couple of weeks and keep all follow-up visits with your healthcare provider. Some complications of hyphema may not show up for several months, so your healthcare provider will want to see you regularly for eye exams. You should also be screened annually for glaucoma.

When to Have a Gonioscopy Eye Exam

A Word from Verywell

A hyphema can occur after any trauma to the eye, but sports injuries are the most common. Wearing protective sports glasses or goggles can be an effective way to reduce the risk for athletes, particularly those who play sports where eye-related injuries are common. This includes basketball, water sports, baseball, and racquet sports. Protective eyewear may be annoying, but it’s worth it if it saves your sight.

5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Ophthalmology.What is hyphema?Gharaibeh A, Savage HI, Scherer RW, Goldberg MF, Lindsley K.Medical interventions for traumatic hyphema.Cochrane Database Syst Rev. 2019;1(1):CD005431. doi:10.1002/14651858.CD005431.pub4Miller KN, Collins CL, Chounthirath T, Smith GA.Pediatric sports- and recreation-related eye injuries treated in US emergency departments.Pediatrics. 2018;141(2). doi:10.1542/peds.2017-3083Belcher CD 3rd, Brown SV, Simmons RJ.Anterior chamber washout for traumatic hyphema. Ophthalmic Surg. 1985 Aug;16(8):475-9. PMID: 4047589.Mompremier M, Sadhwani D, Shaikh S.An office-based procedure for hyphema treatment.Case Rep Ophthalmol Med. 2015;2015:321076. doi:10.1155/2015/321076

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Ophthalmology.What is hyphema?Gharaibeh A, Savage HI, Scherer RW, Goldberg MF, Lindsley K.Medical interventions for traumatic hyphema.Cochrane Database Syst Rev. 2019;1(1):CD005431. doi:10.1002/14651858.CD005431.pub4Miller KN, Collins CL, Chounthirath T, Smith GA.Pediatric sports- and recreation-related eye injuries treated in US emergency departments.Pediatrics. 2018;141(2). doi:10.1542/peds.2017-3083Belcher CD 3rd, Brown SV, Simmons RJ.Anterior chamber washout for traumatic hyphema. Ophthalmic Surg. 1985 Aug;16(8):475-9. PMID: 4047589.Mompremier M, Sadhwani D, Shaikh S.An office-based procedure for hyphema treatment.Case Rep Ophthalmol Med. 2015;2015:321076. doi:10.1155/2015/321076

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Academy of Ophthalmology.What is hyphema?Gharaibeh A, Savage HI, Scherer RW, Goldberg MF, Lindsley K.Medical interventions for traumatic hyphema.Cochrane Database Syst Rev. 2019;1(1):CD005431. doi:10.1002/14651858.CD005431.pub4Miller KN, Collins CL, Chounthirath T, Smith GA.Pediatric sports- and recreation-related eye injuries treated in US emergency departments.Pediatrics. 2018;141(2). doi:10.1542/peds.2017-3083Belcher CD 3rd, Brown SV, Simmons RJ.Anterior chamber washout for traumatic hyphema. Ophthalmic Surg. 1985 Aug;16(8):475-9. PMID: 4047589.Mompremier M, Sadhwani D, Shaikh S.An office-based procedure for hyphema treatment.Case Rep Ophthalmol Med. 2015;2015:321076. doi:10.1155/2015/321076

American Academy of Ophthalmology.What is hyphema?

Gharaibeh A, Savage HI, Scherer RW, Goldberg MF, Lindsley K.Medical interventions for traumatic hyphema.Cochrane Database Syst Rev. 2019;1(1):CD005431. doi:10.1002/14651858.CD005431.pub4

Miller KN, Collins CL, Chounthirath T, Smith GA.Pediatric sports- and recreation-related eye injuries treated in US emergency departments.Pediatrics. 2018;141(2). doi:10.1542/peds.2017-3083

Belcher CD 3rd, Brown SV, Simmons RJ.Anterior chamber washout for traumatic hyphema. Ophthalmic Surg. 1985 Aug;16(8):475-9. PMID: 4047589.

Mompremier M, Sadhwani D, Shaikh S.An office-based procedure for hyphema treatment.Case Rep Ophthalmol Med. 2015;2015:321076. doi:10.1155/2015/321076

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