What Is Hyphema and How Is It Treated?
Injuries are a common cause of hyphema, a condition that happens when blood accumulates in the front part of the eye. You'll need to see an ophthalmologist as soon as possible if you have a hyphema, as vision loss can occur in some cases.
How Can I Tell If I Have a Hyphema?
Hyphemas are hard to ignore. They develop between the iris and pupil and the cornea, the clear rounded tissue covering the iris and pupil. A hyphema can be caused by a small tear in the iris or pupil. Blood from the tear can eventually cover the iris and pupil and interfere with your vision. You may be able to see the blood in your eye, or your ophthalmologist may see it using a slit-lamp, a lighted microscope used to examine your eyes.
If you have a hyphema, you may experience several other symptoms in addition to bleeding, including eye pain and light sensitivity. Your vision may be affected if the blood pools in front of your iris and pupil. Things may look blurry or take on a red tinge, or you may not be able to see at all with the affected eye.
Hyphemas are different than subconjunctival hemorrhages caused by broken blood vessels. If you have a subconjunctival hemorrhage, you may notice a small red spot on the white part of your eye. These hemorrhages usually don't interfere with vision or cause bleeding inside your eye.
Why Are Hyphemas Dangerous?
The blood in your eye can block drainage channels, preventing blood and fluids from exiting the eye. Blockages lead to increased pressure in the eye, which may damage the optic nerve. The optic nerve sends electrical signals between the eyes and the brain. Permanent loss of vision may occur if the optic nerve is damaged. Dangerously high pressure occurs in about 30% of hyphema cases, according to the Journal of Emergency Medicine.
What Causes a Hyphema?
Hyphemas can happen if something hits your eye hard enough to tear the iris or pupil. Injuries from balls, paintball pellets, and airbags can cause hyphemas. Other causes of hyphemas include:
- Diseases. Diseases that affect the blood or cause blood clotting problems, like hemophilia, sickle cell disease, leukemia, or Von Willebrand disease, may increase your risk of developing hyphemas.
- Diabetes. People with diabetes are also at increased risk for a hyphema if the disease causes the growth of new, abnormal blood vessels in the iris. These blood vessels may leak, causing a hyphema.
- Surgery. In some cases, hyphemas develop after eye surgery.
- Tumors. A hyphema may develop if you have a tumor in your eye.
Call your ophthalmologist or go to the emergency room immediately if you notice bleeding in your eye, particularly if you've experienced a blow to the face. Don't try to remove sticks or any foreign objects that may be stuck in your eye.
How Are Hyphemas Treated?
Your ophthalmologist will conduct a few tests to determine the extent of your injury or condition. This may include computerized tomography (CT) or ultrasound scans to assess injuries and tonometry, a simple test that measures the pressure inside your eye.
If you have a hyphema, your eye doctor may recommend:
- Rest. Avoid strenuous activity that could worsen bleeding.
- Patching. Patching your eye for a few days will protect it from further injury.
- Elevating Your Head. Use extra pillows or raise the head of your bed. Elevating your head makes it easier for blood to drain from your eye.
- Using Prescription Eye Drops. Your ophthalmologist may prescribe drops to relieve pain and swelling in your eye.
- Avoiding Aspirin and Ibuprofen. These over-the-counter medications may worsen bleeding.
Bleeding from a minor injury may stop on its own. Major injuries may need surgery to repair damage, clear blood from the eye, or reduce pressure inside the eye. Fortunately, 95% of people with hyphemas don't need surgery, according to the Cleveland Clinic.
Minutes matter when you've had an eye injury or experienced a sudden change in your vision. Call our office immediately if you notice symptoms of hyphema or any other concerning changes in your vision.
Sources:
ScienceDirect: Journal of Emergency Medicine: Spontaneous Hyphema of Vitreous Hemorrhage Causing Secondary Glaucoma in a Patient on Apixaban, 3/2023
https://www.sciencedirect.com/science/article/abs/pii/S0736467922008010
Cleveland Clinic: Hyphema, 3/14/2022
https://my.clevelandclinic.org/health/diseases/22586-hyphema
American Academy of Ophthalmology: What Is Hyphema, 12/8/2023
https://www.aao.org/eye-health/diseases/what-is-hyphema
National Institute of Health: Stat Pearls: Hyphema 12/26/2022
https://www.ncbi.nlm.nih.gov/books/NBK507802/
AAPOS: What Is Hyphema,10/2023
