Prasanta Kumar Nanda1 , Jayaram Meher2 , Bishnuprasad Rath
BACKGROUND An accumulation of blood in the anterior chamber is known as hyphema. An injury to the eye or its surrounding tissue, constitutes most of the calls for emergency in ophthalmology. This study aims to determine the causes and visual outcome following treatment in patients with hyphema following closed globe injury. METHODS This is a prospective study involving 76 patients which done from February 2019 to September 2019 in the Department Of Ophthalmology. Detailed history was taken regarding the type, mode of injury, duration of injury and the eye affected. Lid and adnexal injuries, visual acuity at the time of admission were recorded. Detailed anterior segment evaluation on slit lamp was done. Appropriate treatment was given. The patients were followed after 1 week, and at the end of 6 weeks. RESULTS Majority of patients were males (62 cases, 81%). The most common age group affected was 15-30 years i.e. 65 patients (85%). Sports related injury (32 cases, 42%) was most common cause of hyphema followed by road traffic accident (20 cases, 26%). Of the 76 patients, iris injuries were very common (35 cases). Other ocular findings included- ecchymosis, subconjunctival haemorrhage and angle recession. Moderate blood staining of cornea occurred in 3 patients. The most common form of hyphema in our study was grade-1 seen in 42 patients (55%). Anterior chamber wash done in 10 patients. Rest of the patients were observed carefully. The best corrected vision of 6/24 or better was noted in 68 patients (89%) at the last follow up. CONCLUSIONS Hyphema occurring as a result of blunt trauma, though alarming is also an easily manageable condition if necessary intervention is done early and adequately. Blunt trauma can be prevented by supervising during play or use of adequate protection at work. Early initial presentation for early diagnosis and treatment can help to prevent many ocular complications and better visual outcome after trauma.
