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Hyphema of the Eye

Updated on November 5, 2014

Definition

Hyphema is basically blood in the eye. The bleeding is contained in the anterior chamber, or the front of the eye, between the cornea and the iris.

Causes

Hyphemas are usually caused by injury but can also happen spontaneously. A spontaneous hyphema can be caused by the abnormal growth of blood vessels, a tumor in the eye, uveitis, vascular anomalies, leukemia, hemophilia, diabetes, or complications from eye surgery. They can also be caused by conditions or medications that cause thinning of the blood such as aspirin, warfarin, and drinking alcohol. Mine was caused by a very small piece of plastic hitting me in the corner of the eye.

At the Doctor's Office

Regardless of the cause, hyphemas require immediate attention by an ophthalmologist as they could cause permanent vision impairment. Since the bleeding may partially or completely block vision, you should not drive yourself to the doctor. Do not try to treat the hyphema at home. You could do more harm than good.

The doctor will perform a complete eye exam. A visual acuity test will check how well you can see. The intraocular pressure (the pressure inside the eye) will be checked. A special microscope called a slit lamp will be used to look inside the eye. If the hyphema was caused by sever trauma the doctor might order a CT scan to look at the back of the eye sockets.

There are some questions you might want 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?

•When can I resume normal activity?

•What can I expect to see in the next few days?

If the hyphema was not caused by injury, you'll also want to ask what caused it and what, if any, changes need to be made in your lifestyle to prevent a future recurrence.

At Home Treatment

It is very important to follow the doctor's instructions to prevent rebleeding. The blood usually reabsorbs, but it takes time and careful treatment. If bleeding recurs or pressure increases you may need to be hospitalized. Surgery may be necessary for hyphemas that don't resolve on their own.

Barring complications, treatment is relatively simple.Elevate the head of the bed 45°. Wearing an eye shield may be required at night to prevent accidental rubbing during sleep. A patch may be needed during the day. Do not engage in any strenuous activities. No driving. No computer. Rest the eye as much as possible.

If pain is a problem, acetaminophen can be used in moderation. An increase in pain may indicate an increase in pressure and will require an immediate return to the doctor. Avoid medications containing aspirin or ibuprofen as they thin the blood and may cause a rebleed. Steroids can reduce inflammation but also cause side effects. Dilating eye drops can increase comfort and reduce bleeding, but they can also cause the pupil to stay dilated.

Prevention

There's a reason experts stress the importance of wearing safety glasses. If I had been wearing them I wouldn't have gotten hurt. The best thing you can do to prevent eye injury is to wear safety glasses whenever you're working or playing any sport that has the potential for injury.

For non-injury related hyphema, see your doctor for regular check-ups to catch or monitor any conditions that may result in problems with the eyes. Report any eye pain or vision problems to your doctor so they can be checked out right away. If you're having eye surgery, get to know your surgeon and his background. Ask questions and be informed of the risks involved.

My Story

When I got hit in the eye by a small piece of plastic it took only a few seconds - the time it took me to get to the bathroom mirror - for the corner of my eye to fill with blood. I freaked out a little bit thinking I had seriously injured my eye. I kept expecting the blood to start pouring out, but it didn't. There was no pain other than the initial jolt of a tiny projectile slamming into my eye. My vision was a little blurry, but I could still see.

At the ER I had to wait 2 hours for the doctor. There was an eye chart on the wall across from the chair I was told to sit in. I checked my vision every few minutes to make sure it was still good. No problems.

When the doctor finally got to me she put drops in my eye, flushed it with eye wash, and put dye in it. Then she looked into it with a slit lamp. The plastic that hit me was not there, and she didn't see any serious damage. She said the blood was in the chamber and would be reabsorbed. I didn't know what that meant, but I was so relieved I didn't think to ask any questions.

I was told to not drive or use a computer, limit my reading for 2 or 3 days, and rest my eye as much as possible. I wish I had been given more information so I would have known what to expect while my eye was healing. I didn't know it would get worse before it got better. I didn't know it would take so long. Nobody told me not to rub it if it itched, which it did. I just assumed rubbing it would be bad.

This happened on Tuesday night. From Tuesday to Sunday the blood gradually spread from the inside corner, underneath my eyeball, and part way up the other side. I followed the doctor's instructions but still wondered if I was doing something to keep it from healing. I was set to call my eye doctor first thing Monday morning, but late Sunday afternoon I noticed the blood was starting to get lighter in the corner where it had first appeared. I decided to give it a few more days.

I saw my eye doctor 2 1/2 weeks later for a checkup. There was still a little blood showing, but it had improved significantly by then. He said the eye looked good and it would take another week or so for the blood to go away completely, which it did. I have had no issues with the eye since that time.


While seeing blood in your eye is somewhat scary, it is treatable. The sooner you get to the doctor the better. And prevention is as simple as taking care of and protecting yourself.

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    • RTalloni profile image

      RTalloni 2 years ago from the short journey

      A good look at the importance of safety glasses. Thanks for sharing your experience with tips, including researching the docs.