Timing of Ocular Hypertension After Pediatric Closed-Globe Traumatic Hyphema: Implications for Surveillance

Predictors of Long-term Ophthalmic Complications after Closed Globe Injuries Using the IRIS® Registry (Intelligent Research in Sight)

“… 6 , 43 Nearly 40% of patients who present with traumatic hyphema can develop ocular hypertension, and follow-up schedules and risk stratification tools have been proposed to help identify patients who might require intervention for elevated intraocular pressure. 17 , 45 However, our data suggest that in addition to regular intraocular pressure monitoring and gonioscopy to assess for angle recession, patients who present with hyphema after blunt ocular trauma should also be counseled regarding their increased risk of retinal break and RD both early (0–60 days after trauma) and late (60 days after trauma) and undergo dilated fundus examination for posterior segment monitoring.…”

“…In our study, traumatic hyphema after closed globe ocular trauma was the only concomitant diagnosis that was a significant risk factor for each of the outcomes at any follow-up time period. The majority of the traumatic hyphema literature focuses on the increased risk of ocular hypertension and glaucoma after injury, 17 , 19 , 20 , 28 although some studies do include the risk of cataract development and RD as previously discussed. 6 , 43 Nearly 40% of patients who present with traumatic hyphema can develop ocular hypertension, and follow-up schedules and risk stratification tools have been proposed to help identify patients who might require intervention for elevated intraocular pressure.…”

“…While OGIs often portend worse visual outcomes, closed globe ocular trauma is more common and can also result in severe loss of vision, as the force of injury is largely transmitted to the structures of the eye without an opportunity for release. 16 This subsequent compression and expansion of the globe can damage the anterior segment, causing hyphema, 6 , 17 , 18 , 19 injury to the iris–angle 17 , 20 and traumatic cataract, 9 , 21 and the posterior segment, resulting in vitreous hemorrhage, 7 , 22 , 23 retinal hemorrhage, 24 retinal tears and detachments, 25 choroidal injury, 24 and traumatic optic neuropathy. 20 Compared with OGIs, far fewer studies have evaluated closed globe ocular trauma in a systematic fashion, with the existing literature largely confined to military and pediatric populations.…”