ISSN 2398-2969      

Hyphema

icanis

Introduction

  • Hemorrhage within anterior segment.
  • May or may not be accompanied by posterior segment hemorrhage.
  • Cause: multiple etiologies, may be primary ocular damage or result of underlying coagulopathy.
  • Signs: blood in anterior chamber, may be diffuse or form discrete clot. If unclotted, may collect ventrally and form fluid line.
  • Diagnosis: examination. Underlying condition may need further investigation.
  • Treatment: aimed at controlling intraocular pressure, preventing posterior synechiae/iris bombe and/or secondary glaucoma. Underlying condition should be determined and treated appropriately.
  • Prognosis: variable, depending on etiology. Loss of eye possible.

Pathogenesis

Pathophysiology

  • Hemorrhage occurs when blood vessels from uveal tract are damaged, disrupted or anomalous.
  • Iris vessels most common source, but retinal, choroidal and ciliary vessels are possible.
  • Disruption of uveal tract vessels results in blood leaking into ocular media (aqueous, vitreous).
  • Anterior uveal tract → anterior segment hemorrhage, possibly some escape into posterior segment through suspensory ligament.
  • Etiology may influence whether clot forms in anterior chamber.
    • Uveitis/trauma: blood usually clots.
    • Blood dyscrasias/coumarin intoxication: usually unclotted, may be diffuse (acutely) or form fluid line (as it resorbs).
    • Neoplasia/congenital anomalies/hypertension: usually recurrent - may or may not clot.
  • Unclotted blood and degradation products may block iridocorneal angle (ICA), reducing aqueous outflow → increase in intraocular pressure → glaucoma if not treated.
  • Always accompanied by uveitis Uveitis , so danger of posterior synechiae formation (adhesions between posterior iris and anterior lens) → iris bombe (360° synechiae) → no aqueous exit through pupil, iris root pushed forward blocking ICA → peripheral anterior synechiae (adhesions between iris root and corneoscleral region) → glaucoma.

Timecourse

  • Following single bleeding episode, resorption occurs within 7-14 days.
  • Acute onset.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Harrus S, Ofri R, Aizenberg I & Warer T (1998) Acute blindness associated with monoclonal gammopathy induced by Ehrlichia canis infection. Vet Parasitol 78 (2), 155-160 PubMed.
  • Habin D J & Else D W (1995) Parotid salivary gland adencarcinoma with bilateral ocular and osseous metastases in a dog. JSAP 36 (10), 445-449 PubMed.

Other sources of information

  • Komaromy A Met al(2000)Hyphema - Part II. Diagnosis and treatment.Comp Contin Educ Pract Vet22(1), 74-79.
  • Komaromy A Met al(1999)Hyphema - Part I. Pathophysiologic considerations.Comp Contin Educ Pract Vet21(11), 1064-1069, 1091, 1999.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code