What is Hyphema

Hyphema is bleeding in the eye. This may occur in the front of the eye between the clear covering of the eye (cornea) and the colored part of the eye (iris). You may be able to see the blood in the front part of your eye. A hyphema may be large or small.

Hyphema may be painful and can affect your vision. Treatment is important to prevent permanent loss of vision.

What are the causes?

Eye injury, such as a blow to your eye or upper part of your face, is the most common cause of this condition. Eye surgery can also cause this condition. Other less common causes include:

• Abnormal blood vessels that form in the iris.
• Eye infections.
• Blood clotting disorders.
• Artificial lenses used after cataract surgery.
• Eye cancer.

What increases the risk?

This condition is more likely to occur in people who play sports, especially sports that use small balls. You may also be more likely to develop this condition if you:

• Have a disease that prevents normal blood clotting, such as hemophilia.
• Take certain medicines that thin your blood, such as aspirin.
• Have diabetes.
• Had recent eye surgery.
• Have sickle cell anemia.

What are the signs or symptoms?

The most common symptom of this condition is a pool of blood in the front of your eye. The blood may appear red or black. A very small hyphema may not be visible. A large hyphema may fill part or all of the front part of your eye. Symptoms may also include:

• Blurred vision or vision loss.
• Pain.
• Sensitivity to bright light.

How is this diagnosed?

This condition is diagnosed with a medical history and physical exam. You may have a blood test to check for a bleeding disorder or sickle cell disease. You may also have an eye exam done by an eye specialist (ophthalmologist). This may include:

• Checking your eye with a type of microscope (slit lamp).
• A vision test.
• Measuring the pressure in your eye.

How is this treated?

Treatment depends on the severity of the condition. Many hyphemas go away on their own. Your health care provider will monitor your hyphema closely until it goes away completely. Treatment may also include:

• Restricted activity or bed rest with your head elevated.
• Wearing a cover over your eye (eye shield) to protect it from further injury.
• Stopping all medicines that can increase bleeding, such as aspirin. Only do this as told by your health care provider.
• Eye drops or medicines taken by mouth to control swelling and pressure in your eye.

Eye surgery may be needed to remove the hyphema if other treatments do not help.

Follow these instructions at home:

• Rest in bed as told by your health care provider. Lie on your back and use extra pillows to keep your head raised.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Wear your eye shield as told by your health care provider.
• Do not bend forward or lower your head until your health care provider approves.
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider approves.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

It is important to always wear eye protection when you are doing any activity that can result in eye injury.

Contact a health care provider if:

• You develop pain in the affected eye.
• Your vision is not improving.
• The amount of blood in your eye does not decrease after several days.

Get help right away if:

• Your vision gets worse.
• The amount of blood in your eye increases.
• You feel nauseous or vomit.