What is a Hyphema?

Hyphema is the collection of blood in the anterior chamber of the eye, the space between the cornea and the iris, caused by bleeding or a broken blood vessel in the eye.

The number of accumulated blood grades the severity of the hyphema:

Grade 0 (microhyphema): Collection of blood is not visible but microscopic examination can detect the presence of red blood cells within the anterior chamber.
Grade 1: Less than the lower third of the anterior chamber has blood collection.
Grade 2: The anterior chamber has within a third or a half of blood collection
Grade 3: A half to almost total filling of the anterior chamber has blood.
Grade 4: The entire anterior chamber is filled with blood. It is called “total hyphema” if the blood is bright red or “8-ball hyphema” if it contains black blood.

The risk for loss of vision depends on the grade of the hyphema. The most dangerous type of hyphema is an 8-ball hyphema which is related to circulation reduction of aqueous humor and oxygen reduction in the eye’s anterior chamber.

Hyphema Symptoms

These are the following symptoms typically related to hyphema:

  • Headache
  • Eye pain
  • Blurry or distorted vision
  • Photophobia or light sensitivity


Hyphema Causes

Hyphema often occurs after eye trauma or sustaining an eye injury that leads to having a black eye. It can also occur spontaneously in people who take blood thinners or those with blood clotting disorders. In rare cases, hyphema can happen after eye surgery like cataract surgery.

Treatment for Hyphema

Eye doctor recommends different precautions and treatment based on the grade of the hyphema:

  • Limit on physical activity
  • Elevate the head while sleeping
  • Wear an eye shield
  • Frequent eye check-ups
  • Pain medication
  • Anti-inflammatory medications (topical or oral) and other medicines

Some cases with severe hyphema require surgery.

Intake of over-the-counter pain medications containing aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) is prohibited because it causes further bleeding in the eye.

Frequent eye check-ups are vital after having a hyphema to monitor eye risks that could develop such as elevated eye pressure and glaucoma.


Hyphema Prevention

Wearing safety eyeglasses and other protective eyewear during possible hazardous activities are the best way to prevent traumatic hyphema. Also, wearing protective eye gear when playing sports with high risks of eye trauma like baseball, softball, racquetball, basketball, or hockey is recommended.

Participation in sports like boxing and paintball must include a clear, impact-resistant shield to protect the face and eyes from a high risk of trauma.

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