HYPHEMA

Hyphaema - blood in the anterior chamber.

The blood may fill part or the whole of the anterior chamber.
Bleeding is caused by rupture of iris or ciliary vessels. It
usually ceases quickly.

The danger is not the primary hemorrhage, but possible
secondary hemorrhage. Unless large, the primary hemorrhage
usually absorbs within 24 to 48 hours but may recur.

Treatment:
Admit to hospital
Rest in bed and sedate
Both eyes covered to provide maximum rest to the eyes.

Complications:
Secondary hemorrhage from a broken vessel may occur from the third
to fifth day following injury. Its onset is indicated by sudden pain in the
eye.

If the anterior chamber fills totally with blood (total hyphema) the outflow
channels are likely to block, causing severe secondary glaucoma. The
high intra-ocular pressure not only damages the intra-ocular structures
(iris, retina, lens, optic nerve) but blood constituents are driven into the
cornea through the damaged endothelium (blood staining of the cornea).
Most of such eyes become useless.

Management:
Reduce intra-ocular pressure - Diamox, oral Glycerol, I.V. Mannitol
sometimes surgical removal of blood clot or degradation products.