What is the pathophysiology of hyphema?

Updated: Jan 18, 2019
  • Author: David L Nash, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Hyphema describes the condition of the aqueous humor when red blood cells form a suspension in it.

The choroid and the iris contain a rich complex of vessels. The pupil is outlined and controlled by a complex set of iridial muscles, both sphincters and dilators. These muscles can be ruptured by sharp and/or blunt trauma. This is a frequent source of intraocular hemorrhage (hyphema). In addition, the iris root and/or the ciliary spur is a common location of bleeding from blunt trauma.

Surgical intervention into the eye for anterior segment procedures is accomplished routinely through various approaches. The most commonly used approaches in modern small incision surgery are via the limbus and/or the clear cornea. Clear cornea surgery markedly reduces the risk of bleeding from limbal vessels since the cornea in its healthy state is avascular. Scleral tunnel incision is subject to unpredictable hemorrhage, and the incision must be closed carefully with sutures.

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