Hyphema is the presence of blood in the front chamber of the eye and may partially or completely block vision.  It may present itself as a reddish tinge, or a small pool of blood that develops between the cornea and the iris.  Blood may cover part or all of the iris and pupil.  Hyphemas can cause permanent vision loss and requires immediate attention by an eye doctor.

Symptoms of Hyphema

  • Eye pain
  • Blurry, cloudy or blocked vision
  • Sensitivity to light
  • Bleeding in front of the eye

Type of Hyphemas

  • Traumatic
  • Spontaneous
  • Surgical
  • Neovascular
  • Idiopathic

Traumatic hyphemas are usually caused by an injury that causes a tear to the iris or pupil of the eye, resulting from projectile or a blunt injury that hits the exposed portion eye.  These projectiles can include, rocks, air gun pellets, paint balls, toys, balls or a human fist and usually occurs from accidents while playing sports.  It is important to wear sports glasses or safety goggles when playing sports to avoid the risks of eye injuries.

Spontaneous hyphemas occur without inciting trauma and are usually caused by the abnormal growth of blood vessels, vascular anomalies, uveitis, tumors of the eye, rubeosis iridis, hemophilia, leukemia and other conditions or medications that cause thinning of the blood like warfarin or aspirin.

A surgical hyphema is a complication of intraocular surgery.  Idiopathic hyphema may occur with no known cause or recurrence with spontaneous resolution.

Goals of Hyphema treatment

  • Decreasing the risk of re-bleeding within the eye
  • To prevent damage to the optic nerve
  • To prevent corneal blood staining

Depending on the severity of the hyphema, treatment may consist of methods to control any increase of intraocular pressure including elevating the head at night and wearing a patch and shield (to prevent rubbing of the eye while sleeping causing re-bleeding).  More severe hyphemas that do not respond to medication or non-resolving hyphemas may require surgery.  You may be asked to avoid taking medications containing aspirin because it can lead to more bleeding.  If your eye pressure rises too high, it can lead to glaucoma or damage your cornea and you may need surgery.

If you have sustained an eye injury, or have any of the symptoms listed above, visit your local emergency room right away.