eMedicine Specialties > Ophthalmology > Intraocular Pressure

Glaucoma, Hyphema: Differential Diagnoses & Workup

Author: Inci Irak-Dersu, MD, Assistant Professor, Director of Glaucoma Service, Department of Ophthalmology, University of Arkansas College of Medicine, Jones Eye Institute
Contributor Information and Disclosures

Updated: Dec 28, 2007

Differential Diagnoses

Glaucoma, Uveitic
Juvenile Xanthogranuloma

Other Problems to Be Considered

Hemolytic glaucoma
Ghost cell glaucoma
Hemosiderotic glaucoma

Workup

Laboratory Studies

  • Sickle cell prep: Screen for sickle cell. (This is mandatory upon presentation for non-white patients.)
  • Hemoglobin electrophoresis: Determine if the patient has sickle cell trait or disease.
  • If a bleeding disorder is suspected, prothrombin time (PT), partial thromboplastin time (PTT), platelet count, and liver function tests can be useful. 
  • Aqueous samples from the anterior chamber are occasionally needed to differentiate rare types of glaucoma.

Imaging Studies

  • In selected cases, obtain a CT scan of the orbit to exclude associated orbital fracture or foreign body.
  • Perform ultrasonography to rule out vitreous hemorrhage or retinal detachment.
  • CT and ultrasonography may also help in the diagnosis of other associated eye injuries.

More on Glaucoma, Hyphema

Overview: Glaucoma, Hyphema
Differential Diagnoses & Workup: Glaucoma, Hyphema
Treatment & Medication: Glaucoma, Hyphema
Follow-up: Glaucoma, Hyphema
Multimedia: Glaucoma, Hyphema
References
[ CLOSE WINDOW ]

References

  1. Campbell D, Shields MB, Liebmann JM. Ghost cell glaucoma. In: Ritch R, Shields B, Krupin T, eds. The Glaucomas. Vol 2. 1989:1239-1247.

  2. Culom RD Jr, Chang B, eds. Hyphema and microhyphema. In: The Wills Eye Manual. 1994:32-6.

  3. Drug Facts and Comparisons Staff. Drug Facts and Comparisons. 1999.

  4. Herschler J, Cobo M. Trauma and elevated intraocular pressure. In: Ritch R, Shields B, Krupin T, eds. The Glaucomas. Vol 2. 1989:1225-1237.

  5. Rahmani B, Jahadi HR. Comparison of tranexamic acid and prednisolone in the treatment of traumatic hyphema. A randomized clinical trial. Ophthalmology. Feb 1999;106(2):375-9. [Medline].

  6. Shields MB. Glaucomas associated with intraocular hemorrhage and glaucomas associated with ocular trauma. In: Textbook of Glaucoma. 1992:381-399.

  7. Shingleton BJ, Hersh PS. Traumatic hyphema. In: Eye Trauma. 1991:104-116.

  8. Walton W, Von Hagen S, Grigorian R, Zarbin M. Management of traumatic hyphema. Surv Ophthalmol. Jul-Aug 2002;47(4):297-334. [Medline].

  9. Hersh P, Zagelbaum B, Shingleton B, Kenyon K. Anterior segment trauma. In: Albert D, Jakobiec F, Azar D, Gragoudas E, eds. Principles and Practice of Ophthalmology. 2nd ed. Philadelphia: WB Saunders; 2000:5201-5221.

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

hyphema, microhyphema, hemorrhage in the anterior chamber

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Inci Irak-Dersu, MD, Assistant Professor, Director of Glaucoma Service, Department of Ophthalmology, University of Arkansas College of Medicine, Jones Eye Institute
Inci Irak-Dersu, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Arkansas Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Andrew I Rabinowitz, MD, Consulting Staff, Department of Ophthalmology, Barnet Dulaney Perkins Eye Center
Andrew I Rabinowitz, MD is a member of the following medical societies: Aerospace Medical Association, American Academy of Ophthalmology, and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Martin B Wax, MD, Clinical Professor, Department of Ophthalmology, University of Texas Southwestern Medical School; Vice President, Ophthalmology Research and Development, Head, Ophthalmology Discovery Research, Alcon Labs, Inc
Martin B Wax, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Society for Neuroscience
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.