OPHTHALMOLOGY
TRAUMATIC HYPHEMA
PromptHistory
ResponseHit in face by Tennis/squash/football
Prompt
Response
PromptPhoto descriptions
ResponseMacrohyphema with visible blood line
Irregular pupil
Conjuctival injection
Traumatic mydriasis
+/- presence of flouricine (Seems to score marks on lots of ophthal pics)
Irregular pupil
Conjuctival injection
Traumatic mydriasis
+/- presence of flouricine (Seems to score marks on lots of ophthal pics)
PromptTraumatic Hyphema Grading
ResponseI = ⅓
II =⅓ to ½
III= ½ to sub-total
IV = Total
(memory aide: Wrong but close - stage = number of quarters involved. Eg. Stage II = 2 quarters etc)
II =⅓ to ½
III= ½ to sub-total
IV = Total
(memory aide: Wrong but close - stage = number of quarters involved. Eg. Stage II = 2 quarters etc)
PromptAssociated injuries of traumatic hyphema
ResponseLens dislocation
Globe rupture
Orbital wall fracture
Retinal detachment
Globe rupture
Orbital wall fracture
Retinal detachment
PromptManagement of traumatic hyphema
ResponseAnalgesia (avoid NSAID’s/Aspirin) - Drugs + Doses
Patch eye
Bed rest, head elevated 30 degrees to aid settling of hyphema
Topical cycloplegics (tropicamide)
Treat associated complications
Ophthalmology review
Patch eye
Bed rest, head elevated 30 degrees to aid settling of hyphema
Topical cycloplegics (tropicamide)
Treat associated complications
- Raised IOP with acetazolamide/topical timolol
- Traumatic irdocyclitis - steroids/cycloplegics
Ophthalmology review
PromptComplications of traumatic hyphema
ResponseEarly:
Rebleed
Traumatic iritis (eye pain, tearing, photophobia)
Glaucoma/Raised IOP
Late:
Corneal blood staining
Posterior/peripheral anterior synechiae
Optic atrophy
Rebleed
Traumatic iritis (eye pain, tearing, photophobia)
Glaucoma/Raised IOP
Late:
Corneal blood staining
Posterior/peripheral anterior synechiae
Optic atrophy