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Traumatic hyphema: Management

Christopher M Andreoli, MD
Matthew F Gardiner, MD
Section Editors
Richard G Bachur, MD
Jonathan Trobe, MD
Maria E Moreira, MD
Deputy Editor
James F Wiley, II, MD, MPH


Traumatic hyphema, or blood in the anterior chamber, is a common complication of blunt or penetrating injury to the eye and can result in permanent vision loss. Once life-threatening injuries are addressed, the goals of initial assessment include recognition and characterization of the hyphema and identification of associated orbital and ocular injuries. Although discussed separately, the assessment and management are performed jointly in practice (table 1).

If an orbital compartment syndrome or open globe is suspected, then emergent consultation with an ophthalmologist is critical to help preserve vision. In addition, optimal outcome following a hyphema depends upon early ophthalmologic intervention focused on prevention of rebleeding and avoidance of intraocular hypertension. In most instances, patients recover with vision intact. Vision loss is more likely in patients with large hyphemas, sickle hemoglobinopathies, or bleeding dyscrasias.

This review covers the initial and definitive management of traumatic hyphemas. Clinical features and diagnosis of traumatic hyphemas are discussed separately. (See "Traumatic hyphema: Clinical features and diagnosis".)


A rapid overview summarizes the important clinical features and initial management of traumatic hyphema (table 1).

The clinician should first address life-threatening and immediate vision-threatening conditions before proceeding with specific treatment of a traumatic hyphema as follows:

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Literature review current through: Nov 2017. | This topic last updated: Oct 21, 2016.
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