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At least 19 recordsLinked to original sources

PubMed1979

Sickled erythrocytes, hyphema, and secondary glaucoma: I. The diagnosis and treatment of sickled erythrocytes in human hyphemas.

Four patients with sickle cell hemoglobinopathies (one SC, three AS) and hyphemas were found to have more erythrocytes sickled in their anterior chambers than in their circulating venous blood. Intraocular pressure was severely elevated, despite relatively small amounts of intracameral blood. Systemic hypotensive agents were not always successful in reducing IOP, and in patients with sickle cell hemoglobinopathy, are probably contraindicated in high or repeated dose regimens. Moderate elevation of IOP in sickle cell hemoglobinopathy patients may produce rapid deterioration of visual function, perhaps because of a greater than usual effect on vascular perfusion in the central retinal artery and optic nerve. Early anterior chamber paracentesis may be the best treatment for this type of hyphema-induced secondary glaucoma.

Adolescent↗

PubMed2005

[Traumatic hyphema caused by eye injuries].

Hyphema is a common consequence of mechanical ocular trauma. Blood in the anterior chamber (hyphema)can occur after blunt or lacerating trauma. Traumatic hyphema is a diagnostic and therapeutic emergency. Major complications of hyphema include secondary hemorrhage, secondary glaucoma, corneal staining and disturbances in visual acuity. The aim of our study was the retrospective analysis of patients with posttraumatic hyphema. According to a prospective protocol we studied 428 patients who were examined and treated at the Emergency Department of Department of Ophthalmology Medical University of Gdansk between 1998-2004 years (ears). Data obtained included age and sex. 81% of patients were man, 19% of patients were women. Mean age of patients with ocular hyphema 6-72 years. We determined initial and final visual acuities (visual acuity - distance Snellen acuity test), intraocular pressure measurement, biomicroscopy, fundus indirect ophthalmology, gonioscopy and US- examinations (sometimes). Data obtained also were: slitlamp examinations for hyphema size, hyphema grading and corneal clarity. Most hyphemas were small, occupying less than one- third of the volume of the anterior chamber. The most common associated injuries to the eye hyphema included corneal oedema, glaucoma (secondary glaucoma), cataract and mydriasis. Traumatic hyphema is therapeutic emergency. More preventive efforts (hospitalization) were necessary, especially for children. In our study we observed 89% patients with traumatic hyphema due to non - penetrating eye injury. The assault were responsible for hyphema in 30.1% of cases and traffic accidents in 38.7% of all hyphemas. Treatment of the hyphema is generally topical. Outcome is good (in more cases), if medical treatment was quickly instituted. Surgical treatment must be reserved for a special cases, but it needs more further investigations.

Adolescent↗

PubMed2004

Outpatient management of traumatic hyphema in children: prospective evaluation.

PURPOSE: To evaluate the clinical outcome of children with traumatic hyphema treated on an outpatient basis. METHODS: A prospective cases series. Thirty-five children with traumatic hyphema were treated as outpatients for the ocular injury from February 2002 to February 2003. Data regarding initial and final visual acuity, slit-lamp biomicroscopy, hyphema size,ophthalmoscopy, intraocular pressure, rebleeding, clearance time, and medical and surgical intervention were recorded. RESULTS: Thirty (85.7%) children were male, and the major cause of traumatic hyphema was domestic tools (14 cases, 40.0%). Twenty-four patients (68.6%) presented low grades of hyphema. Seventeen patients (48.6%) had intraocular pressures higher than 24 mm Hg. The most common lesions associated with traumatic hyphema were corneal injuries (16 cases, 45.7%). The median final visual acuity was 20/25. Unsatisfactory final visual acuity (worse than 20/30) was statistically associated with ocular posterior segment lesions (P = 0.009) and grade of hyphema (P = 0.004). The grade of hyphema was also related to intraocular hypertension (P = 0.018) and time for hemorrhage absorption (P < 0.001). Nine patients (25.7%) underwent surgical intervention. Rebleeding occurred in three patients (8.6%). CONCLUSIONS: Outpatient management is a feasible option for children with hyphema. Associated posterior ocular segment injuries and hyphema of greater magnitude were related to the worst final visual acuities.

Adolescent↗

PubMed1999

Effect of melanin on traumatic hyphema in rabbits.

OBJECTIVE: To investigate the role of melanin in influencing the clearance of traumatic hyphema and in the incidence of rebleeds following the hyphemas. METHODS: Hyphemas were induced in 30 eyes of New Zealand white albino rabbits using an Nd:YAG laser. A total of 3.75 mg of synthetic melanin suspended in 0.1 mL of balanced salt solution was introduced into the anterior chambers of 16 animals. A total of 0.1 mL of balanced salt solution was injected into 14 control eyes. Hyphema levels were measured by a masked observer (V.D.B.) daily for 15 days. Pairs of animals were sacrificed at 1, 3, 5, 10, and 15 days and the eyes studied histologically. RESULTS: Hyphemas were consistently produced in all eyes with mean+/-SD levels of 1.44+/-0.22 mm and 1.57+/-0.24 mm in the melanin-treated and control eyes, respectively. The clearance of hyphemas in the melanin-treated eyes was significantly prolonged throughout the study (P<.001). The rate of rebleed in the melanin-treated group was 18.8% and in the control group was 7.1% (P<.01). Histologically, both groups showed variable degrees of blood in the anterior chambers and trabecular meshwork. In addition, the melanin-treated eyes showed free melanin, melanin-laden macrophages, and an inflammatory response in the anterior chamber and trabecular meshwork that was greater than that in the control eyes. Melanin-treated eyes with rebleeds showed organized hemorrhage with neovascularization. CONCLUSIONS: The presence of melanin results in a significantly prolonged course of hyphemas and may influence the rate of rebleeds. Occlusion of the trabecular meshwork with melanin-laden macrophages and inflammation may be the mechanisms responsible for these effects. CLINICAL RELEVANCE: The release of melanin into the anterior chamber during ocular trauma may be partly responsible for the susceptibility of darker-pigmented individuals to more serious complications following a traumatic hyphema.

Animals↗

PubMed1998

Traumatic hyphema: outcomes of outpatient management.

OBJECTIVE: This study aimed to compare the outcomes of outpatient and inpatient management of layered hyphema. DESIGN: The charts of all patients with traumatic layered hyphema treated in the Massachusetts Eye and Ear Infirmary Emergency Ward between January 1991 and November 1995 were analyzed retrospectively. Patients with a diagnosis of microscopic hyphema, ruptured globe, or posterior segment injury other than commotio retinae on their initial emergency department visit were excluded. The study patients were compared with an historic control group of patients with hyphema who had been treated at the same institution from July 1986 to February 1989. PARTICIPANTS: A total of 154 patients met the study criteria. These were compared with 119 patients in the historic control group. INTERVENTION: Of the study patients, 5% were admitted on the day of presentation, 95% were treated initially as outpatients, and 4% subsequently were admitted. All of the patients in the historic control group were treated with initial hospital admission. MAIN OUTCOME MEASURES: The rebleed rates of the study and control groups were compared. The final recorded visual acuity and causes of best-corrected visual acuity worse than 20/30 were analyzed for the study group. RESULTS: The rebleed rates of the study group and the historic control group were 4.5% and 5.0%, respectively (P > 0.05). The rebleed rates of the study patients initially treated as outpatients and the historic control group were 3.4% and 5%, respectively (P > 0.05). The rebleed rates of study patients who did not receive aminocaproic acid and the subset of historic control patients who received aminocaproic acid were 3.3% and 4.8%, respectively (P > 0.05). Ninety-six percent of study patients achieved a final best-corrected visual acuity of 20/30 or better. Causes of a final documented visual acuity worse than 20/30 included loss of patient follow-up before resolution of the hyphema, traumatic cataract, macular hole, and macular degeneration. CONCLUSIONS: In the authors' predominantly white patient population, close outpatient follow-up of traumatic hyphemas appears to be safe and effective. Hospitalization for hyphema does not appear to decrease the rate of rebleeding. Decreased vision in the setting of traumatic hyphema generally results from comorbidities not affected by inpatient management.

Adolescent↗

PubMed1984

Echographic detection and classification of posterior hyphemas.

A 'posterior hyphema' (in analogy to the classic hyphema seen in the anterior chamber) is a collection of liquid blood at the bottom of a fluid-filled space in the posterior segment of the eye. The horizontal surface of a posterior hyphema produces strong signals echographically which, at first glance, may be confused with signals from a retinal detachment or a preretinal membrane. With the patient being examined in a supine position, a retinal detachment of the inferior posterior fundus involving the macula is suggested. Such a misdiagnosis would have serious consequences for the management of a patient and must be avoided. A simple, quick and effective (both highly sensitive and specific) echographic (A-scan and B-scan) shift technique clearly differentiates a posterior hyphema from a retinal detachment and a preretinal membrane. This shift method has been applied successfully in 62 consecutive cases of posterior hyphema. These represent 20% of 304 cases with severe posterior segment hemorrhages examined echographically in a 3-year period. With echography, the height of a posterior hyphema can be measured precisely and its consistency ranging from very liquid ('thin' hyphemas) to highly viscous ('thick' and 'sticky' hyphemas) can be determined. Thus, echography contributes important information about this special kind of posterior segment hemorrhage, particularly useful in previtrectomy evaluations.

Diagnosis, Differential↗

PubMedDate not supplied

Management of traumatic hyphema.

Hyphema (blood in the anterior chamber) can occur after blunt or lacerating trauma, after intraocular surgery, spontaneously (e.g., in conditions such as rubeosis iridis, juvenile xanthogranuloma, iris melanoma, myotonic dystrophy, keratouveitis (e.g., herpes zoster), leukemia, hemophilia, von Willebrand disease, and in association with the use of substances that alter platelet or thrombin function (e.g., ethanol, aspirin, warfarin). The purpose of this review is to consider the management of hyphemas that occur after closed globe trauma. Complications of traumatic hyphema include increased intraocular pressure, peripheral anterior synechiae, optic atrophy, corneal bloodstaining, secondary hemorrhage, and accommodative impairment. The reported incidence of secondary anterior chamber hemorrhage, that is, rebleeding, in the setting of traumatic hyphema ranges from 0% to 38%. The risk of secondary hemorrhage may be higher in African-Americans than in whites. Secondary hemorrhage is generally thought to convey a worse visual prognosis, although the outcome may depend more directly on the size of the hyphema and the severity of associated ocular injuries. Some issues involved in managing a patient with hyphema are: use of various medications (e.g., cycloplegics, systemic or topical steroids, antifibrinolytic agents, analgesics, and antiglaucoma medications); the patient's activity level; use of a patch and shield; outpatient vs. inpatient management; and medical vs. surgical management. Special considerations obtain in managing children, patients with hemoglobin S, and patients with hemophilia. It is important to identify and treat associated ocular injuries, which often accompany traumatic hyphema. We consider each of these management issues and refer to the pertinent literature in formulating the following recommendations. We advise routine use of topical cycloplegics and corticosteroids, systemic antifibrinolytic agents or corticosteroids, and a rigid shield. We recommend activity restriction (quiet ambulation) and interdiction of non-steroidal anti-inflammatory agents. If there is no concern regarding compliance (with medication use or activity restrictions), follow-up, or increased risk for complications (e.g., history of sickle cell disease, hemophilia), outpatient management can be offered. Indications for surgical intervention include the presence of corneal blood staining or dangerously increased intraocular pressure despite maximum tolerated medical therapy, among others.

Adrenal Cortex Hormones↗

PubMed1975

Traumatic hyphema: surgical vs medical management.

We undertook a prospective study of traumatic hyphema during the years 1970 through 1972 to compare the effects of medical management and surgical evacuation in the more severe hyphemas. A protocol for sutdy of the two regimens enabled us to compare the results of therapy. The findings indicate that medical management is preferable for the initial 4 days in major hyphemas. Surgical intervention does not offer improvement in the poor prognosis of total hyphemas during this early period. The incidence of complications and the incidence of permanent poor visual results are higher in surgically treated patients than in those managed medically. Surgical intervention should be reserved for cases showing: (1) microscopic corneal blood staining; (2)total hyphemas with intraocular pressures of 50 mm Hg or more for 5 days (to prevent optic nerve damage); (3) hyphemas that are initially total and do not resolve below 50% at 6 days with intraocular pressures of 25 mm Hg or more (to prevent corneal blood staining); and (4) hyphemas that remain unresolved for 9 days (to prevent peripheral anterior synechiae). A brief review of problems that may be encountered in the various forms of surgical management is included in an effort to prevent repeating similar pitfalls.

Adult↗

PubMed1991

Intraocular tissue plasminogen activator in a rabbit model of traumatic hyphema.

Tissue plasminogen activator was used to evaluate the clearance of traumatic hyphema in a rabbit model. A neodymium-YAG laser was used to disrupt iris vessels, creating a traumatic hyphema. Tissue plasminogen activator (1800 IU/0.1 mL) was injected into the anterior chamber 24 hours after creation of the hyphema. Two control groups (one receiving balanced salt solution and one receiving no treatment) were used for comparison. A multivariate analysis of covariance indicated that the greatest difference in hyphema clearance between the groups occurred at days 3, 4, and 5. Five days after tissue plasminogen activator treatment, the mean size of the clot remaining in the anterior chamber was 27% of that of the original hyphema. In control eyes, almost 60% of the original clot remained at day 5. Treatment of animals with tissue plasminogen activator doses of 5000 IU and 10,000 IU produced a substantial increase in repeated bleeding episodes in our rabbit model. We concluded that although the use of tissue plasminogen activator in our rabbit model of traumatic hyphema significantly improved clearance of blood from the anterior chamber, the remaining clot was of such size that the clinical benefit was questionable.

Animals↗

PubMed1997

Topical aminocaproic acid in the treatment of traumatic hyphema.

OBJECTIVES: To determine whether topically applied aminocaproic acid, like systemic aminocaproic acid, effectively reduces secondary hemorrhage after hyphemas and to compare the safety and effectiveness of topical application with those of systemic use and a control group. DESIGN: A prospective, randomized, double-masked, multicenter study. PATIENTS: Sixty-four patients with traumatic hyphema treated with topical or systemic aminocaproic acid and compared with 54 control patients with hyphema. Daily slitlamp examinations for hyphema grading and corneal clarity, initial and final visual acuity, applanation tonometry, and fundus indirect ophthalmoscopy were studied. Follow-up was 6 months to 5 1/2 years (mean, 2.96 years). RESULTS: Compared with the control group, topical and systemic aminocaproic acid was statistically significant in preventing secondary hemorrhage. Only 3% (2/64) of the patients who received topical or systemic aminocaproic acid had secondary hemorrhage compared with 22% (12/54) of the control group (P = .002). Final visual acuity was 20/40 or better in 30 patients (86%) in the topical group compared with 23 patients (43%) in the control group (P < .001). Final visual acuity was 20/40 or better in 20 patients (69%) in the systemic aminocaproic acid group compared with 23 patients (43%) in the control group (P = .04). The topical aminocaproic acid group had a final visual acuity of 20/40 or better in 86% of patients, compared with 69% of patients in the systemic group. CONCLUSIONS: Topical aminocaproic acid appears to be a safe, effective treatment to prevent secondary hemorrhage in traumatic hyphema. It is as effective as systemic aminocaproic acid in reducing secondary hemorrhage. No systemic side effects were observed with topical use. Topical aminocaproic acid provides an effective out-patient treatment for traumatic hyphemas.

Administration, Topical↗

PubMed1997

Sickle cell trait as a risk factor for secondary hemorrhage in children with traumatic hyphema.

PURPOSE: To determine risk factors for secondary hemorrhage and poor visual outcome in children with traumatic hyphemas. METHODS: We reviewed 99 eyes of 97 children younger than 18 years who had been hospitalized for hyphema within 48 hours of blunt eye trauma. Inpatient records were examined for race, age, sickle cell trait status, size of hyphema and intraocular pressure at admission, secondary hemorrhage (rebleed of hyphema), and medications while hospitalized. Fifty-five eyes of 53 children had at least 1 month of follow-up or attained best-corrected visual acuity of 20/50 or better at their last outpatient visit. RESULTS: Among 99 eyes of 97 children with traumatic hyphema, secondary hemorrhage occurred in nine eyes (9%). Among 72 eyes of 70 African-American children, secondary hemorrhage occurred in nine eyes (14%), whereas in 27 eyes of 27 white children, there were no secondary hemorrhages. However, when the 14 eyes of 13 sickle cell trait-positive children were excluded from the African-American group, the 57 eyes of sickle cell trait-negative African-American and white children did not have any secondary hemorrhages. The sickle cell trait-positive group had secondary hemorrhages in nine of 14 eyes (64%), significantly (P < .005) different from the 0% rate in the 57 eyes of African-American sickle cell trait-negative and white children. The sickle cell trait-positive group also had higher intraocular pressure and permanent visual impairment. CONCLUSION: Sickle cell trait is a significant risk factor for secondary hemorrhage, increased intraocular pressure, and permanent visual impairment in children who have traumatic hyphemas following blunt trauma.

Administration, Topical↗

PubMed1999

An analysis of risk for secondary hemorrhage in traumatic hyphema.

OBJECTIVE: Factors such as size of hyphema, intraocular pressure, initial visual acuity, and use of steroids or antifibrinolytic drugs may be associated with the likelihood of rebleeding in traumatic hyphema. The association of the visual outcome with secondary hemorrhage has been questioned. DESIGN: Randomized, placebo-controlled, clinical trial. PARTICIPANTS: Two hundred and thirty-eight patients who had hyphema develop after blunt trauma. INTERVENTION: Eighty patients received oral tranexamic acid, 80 patients received placebo, and 78 patients received oral prednisolone. MAIN OUTCOME MEASURES: Secondary hemorrhage and vision at the time of discharge from the hospital were measured. RESULTS: Rebleeding occurred in 43 (18%) of the patients and was prevented significantly by oral tranexamic acid compared with the placebo (odds ratios [OR] = 0.39; 95% confidence interval [CI], 0.17, 0.89). Occurrence of secondary hemorrhage had weak associations with initial high intraocular pressure (OR = 2.7; 95% CI, 0.99, 7.3) and initial visual acuity of 6/60 or less (OR = 1.8; 95% CI, 0.9, 3.7). Secondary hemorrhage had no statistical association with age, gender, oral prednisolone, size of hyphema, and retinal damage. Visual acuity of 6/60 or less at the time of discharge was significantly associated with rebleeding (OR = 10.5; 95% CI, 3.7, 29.2), initial visual acuity of 6/60 or less (OR = 9.9; 95% CI, 2.8, 38.0), retinal damage (OR = 14.6; 95% CI, 3.8, 55.8), and male gender (OR = 6.5; 95% CI, 1.4, 31.9). Final visual acuity had no significant statistical association with age, use of oral prednisolone or tranexamic acid, and size of hyphema. CONCLUSIONS: High intraocular pressure and low vision at the time of first examination may be associated with increased chance of rebleeding. Retinal damage, secondary hemorrhage, male gender, and initial poor vision are associated with a worse visual outcome in patients with traumatic hyphema.

Administration, Oral↗

PubMed1980

Changes in outflow facility in experimental hyphema.

To characterize the pathophysiology of hyphema clearance, we studied changes in the facility of outflow in experimental hyphema in freshly enucleated rabbit eyes. Hyphemas, with washed normal or sickled red cells (RBCs) (suspended in isotonic phosphate buffer to obtain a hematocrit value comparable to that of whole blood) and occupying 50% to 100% of the anterior chamber volume, caused a marked cell "crowding" in the chamber angle and an increase in the outflow resistance; the facility stabilized at a value 60% lower than the control (p = < 0.001). No significant change in outflow facility was observed in hyphemas of either RBC type occupying 25% of the anterior chamber volume (p = N.S.). Whole blood hyphema occupying 50% of the anterior chamber volume reduced the facility of outflow by 80% of the control mock aqueous value (p = < 0.001); a comparison with 50% hyphema produced by washed RBCs indicated a significant contribution by the plasma (fibrin) component (p = 0.0025) in increasing the resistance to outflow.

Anemia, Sickle Cell↗

PubMed1977

Recurrent traumatic hyphema. A sequel of injury to the Schlemm canal.

A patient with recurrent hyphema following blunt trauma to the left eye was found to have an angle recession with a laceration of the trabecular meshwork and Schlemm canal. Active bleeding from the Schlemm canal proved to be the cause of the recurrent hyphema. Repeated trials of bed rest and bilateral eye patching provided only temporary control of the bleeding. Cessation of the active bleeding and subsequent resolution of the hyphema was achieved following argon laser photocoagulation to the traumatized portion of the Schlemm canal. While hyphema is a common manifestation of blunt ocular trauma, visible rupture of the Schlemm canal is most unusual. This paper describes the gonioscopic findings of a rupture of the Schlemm canal in a patient who had a traumatic hyphema and recurrent bleeding.

Adult↗

PubMed1990

Rebleeding in experimental traumatic hyphema treated with intraocular tissue plasminogen activator.

Tissue plasminogen activator has recently been shown to enhance the clearance of experimental nontraumatic hyphema in animals. However, hyphema in human eyes usually results from ocular trauma, and rebleeding is a serious complication. Hemorrhage is also a potential complication of fibrinolytic therapy. We assessed the incidence of rebleeding in an animal model of surgically induced traumatic hyphema after intracameral injection of tissue plasminogen activator (25 micrograms) or physiological saline. Eight eyes were each treated with tissue plasminogen activator or physiological saline at 10 minutes, 24 hours, 48 hours, or 72 hours after injury. Controls were 8 eyes with hyphema but no intracameral injection. No eyes treated with physiological saline (total, 32 eyes) or control eyes rebled. In contrast, the incidence of rebleeding from the injury site in eyes treated with tissue plasminogen activator was 88% (7/8) at 10 minutes, 75% (6/8) at 24 hours, 50% (4/8) at 48 hours, and 0% (0/8) at 72 hours after injury. Treatment of traumatic hyphema with tissue plasminogen activator prior to healing of damaged vascular endothelium may contribute to rebleeding.

Animals↗

PubMed1999

Photocoagulation of iris nevus to control recurrent hyphema.

PURPOSE: To report a case of recurrent hyphema caused by an iris nevus that was successfully treated with photocoagulation. METHOD: Case report. In a 30-year-old woman with recurrent hyphema secondary to an iris nevus, photocoagulation was applied to the iris nevus. RESULTS: Before photocoagulation of the iris nevus, the patient had increasing frequency of hyphema episodes. After treatment, no hyphema episodes occurred during 13 months of observation. CONCLUSION: Photocoagulation of the surface of an iris nevus may prevent recurrent hyphema.

Adult↗

PubMed1993

High-frequency ultrasound imaging and spectral analysis in traumatic hyphema.

PURPOSE: High-frequency (50-MHz) ultrasound allows high-resolution imaging of anterior ocular structures. Spectrum analysis of acoustic backscatter is sensitive to the concentration, size, and density of tissue inhomogeneities. The authors sought to determine whether acoustic imaging and spectrum analysis of hyphema would allow them to distinguish organized from fluid hyphema and recent from old hemorrhage in the eye. METHODS: Trauma-induced hyphemas were followed by slit-lamp photography and high-frequency ultrasonography in six New Zealand white rabbits. The blood collections were analyzed using the normalized power spectra of the digitized radio frequency ultrasound data and compared with in vitro references. RESULTS: The 50-MHz acoustic images permitted differentiation between fluid (diffuse) and clotted (organized) blood. Spectrum analysis allowed quantitative characterization of the degree of blood organization. Significant changes were observed in spectral properties during the time course of absorption both for initial and after-rebleeding hemorrhages. The characteristics of a human postsurgical hyphema also were examined and found to be similar to those seen in the experimental model. CONCLUSION: Spectrum analysis of high-frequency ultrasound data was able to distinguish organized from recent hemorrhage, which is clinically helpful for planning hyphema therapy.

Animals↗

PubMed2005

Management of prominent iris vascular tufts causing recurrent spontaneous hyphema.

PURPOSE: To report the management of recurrent, spontaneous hyphema associated with florid iris vascular tufts in a patient presenting for cataract surgery. METHODS: Interventional case report and review of the literature; presentation of clinical findings, iris angiography, and the argon laser regimen used to minimize potential corneal complications with increased total treatment energy. RESULTS: An 80-year-old man with a 20-year history of bilateral, recurrent, spontaneous hyphema associated with extensive iris vascular tufts presented with visually significant cataracts. Serial argon laser photocoagulation treatment of the prominent, circumferential iris vascular tufts of the left eye arrested further episodes of spontaneous hyphema and facilitated uneventful cataract surgery. Argon laser parameters were titrated to therapeutic effect during the initial treatment sessions, and sectoral photocoagulation of the circumferential vascular tufts was performed during a 5-month period to accommodate increased laser power and energy. The total energy required to complete treatment of the extensive lesions was substantially more than that in similar previous reports; however, no adverse corneal complications were associated with the laser therapy. CONCLUSIONS: This case appears to represent the first description of chronic, bilateral, recurrent spontaneous hyphema associated with iris vascular tufts. Argon laser treatment of symptomatic iris vascular tufts promotes resolution of recurrent, spontaneous hyphema and may serve to mitigate the risk of hemorrhage from these lesions during subsequent intraocular surgery. Conservative management of increased total treatment energy may minimize the potential risk of corneal decompensation with argon laser therapy.

Aged↗