Management of Traumatic Hyphema

Global Current Practice Patterns for the Management of Hyphema

“…2 Other trials have found that systemic and/or topical steroids may be beneficial for preventing rebleeds. 8 Despite a lack of conclusive evidence, the vast majority of experts in our study routinely administered topical steroids to patients with gross hyphema or microhyphema (n = 34, 94.4%, and n = 29, 80.6%, respectively). Because topical steroids have limited side effects compared to systemic administration, they would be preferred if they are found to be similarly effective.…”

“…Previous investigations thus far have shown management techniques to affect secondary hemorrhage rates, but not necessarily improve visual outcomes. 1,2,8,9,32 However, evidence-based management protocols are still needed to reduce clinical waste, limit unnecessary exposure to medication side effects or adverse surgical events, and ensure access to optimal care.…”

Traumatic Hyphema: Diagnostic and Management Considerations

“…Conservative measures typically include minimized physical activity, the elevation of the head to encourage inferior blood layering/minimization of a clot in the central visual axis, and shielding of the affected eye. Some have advocated for strict bed rest, with studies by Romano and Robinson 29 and Yasuna 33 reporting superior rebleeding rates through a protocol of hospitalization and bed rest for 5 days, along with oral steroids and avoidance of routine tonometry. Other studies have not shown conclusive differences in outcomes with strict bed rest during outpatient management, 23,[44][45][46] though it is worth noting that these studies are not randomized and typically involve small, specific patient populations.…”

Treatment and prognosis in hyphema patients with high intraocular pressure

“…11,28,29 Ayrıca rehemoraji ile glokom, pupiller blok, disk hematik, periferik ön sineşi ve sonuç görme keskinliğinin olumsuz etkilendiğini gösteren çalışmalar bulunmaktadır. 10,30 Bazı çalışmalarda ise sekonder kanamanın prognoza etkili olmadığı, esas etkili faktörlerin hifema seviyesi ve arka segment komplikasyonları olduğu belirtilmiştir. 22 Çalışmamızda rehemoraji gelişen 5 hastanın sonuç görmelerine baktığımızda 3 hastanın görme keskinlikleri seviyelerinin 1,0 olduğu, 2 hastanın retinal patoloji nedeniyle 1 metreden parmak saydığı tespit edilmiştir.…”