Glaucoma, Hyphema Workup

  • Author: Inci Irak-Dersu, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 24, 2010
 

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.
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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.
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Other Tests

Ultrasound biomicroscopy is a useful tool to identify angle recession or cyclodialysis cleft occurs following hyphema/ocular trauma.

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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Inci Irak-Dersu, MD  Associate 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, American Society of Cataract and Refractive Surgery, and Arkansas Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

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.

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.

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.

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.

References

  1. Sihota R, Kumar S, Gupta V, et al. Early predictors of traumatic glaucoma after closed globe injury: trabecular pigmentation, widened angle recess, and higher baseline intraocular pressure. Arch Ophthalmol. Jul 2008;126(7):921-6. [Medline].

  2. 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].

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

  4. Hack KM, Pedersen R. Mental status changes and bradycardia: don't forget the eye! Traumatic hyphema can mimic increased intracranial pressure. Clin Pediatr (Phila). Apr 2009;48(3):331-3. [Medline].

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

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

  7. Drug Facts and Comparisons Staff. Drug Facts and Comparisons. 1999.

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

  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.

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

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

 
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Layered hyphema from blunt trauma.
Total or 8-ball hyphema.
 
 
 
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