What are the possible complications of hyphema glaucoma?

Updated: Jul 29, 2020
  • Author: Inci Irak Dersu, MD, MPH; Chief Editor: Hampton Roy, Sr, MD  more...
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Corneal bloodstaining is one complication of long-standing hyphema in association with glaucoma. Both hemosiderin and hemoglobin collect in the stroma and give the cornea a yellowish appearance. It usually spontaneously resolves in years. When there is suspicion of corneal bloodstaining in the early stages, the hyphema should be cleared surgically. Washing out the anterior chamber long after the incident has been found to be useful to clear bloodstaining. Anterior segment structures can become difficult to visualize.

Glaucoma may lead to optic atrophy; this is especially true in patients with sickle cell. Always consider early surgical intervention in resistant cases. A long period of high IOP (ie, 50 mm Hg lasting longer than 5 d) is dangerous.

The most severe complication of hyphema is not the initial bleed but rather a rebleed, which is usually seen within 72 hours following the initial trauma. The rebleeding rate is 10-20%. Hyphema resulting from a rebleed usually is more extensive than that seen with the initial trauma. Rebleeding may present as total hyphema with blood filling the entire anterior chamber, often called 8-ball hyphema. Such significant hemorrhages often lead to elevated IOPs and corneal bloodstaining. They also are more likely to require surgical care. Peripheral anterior synechia is another complication and is associated with larger hyphemas and longer durations.

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