Outpatient management of traumatic hyphemas in children.
OBJECTIVE
There are no outcome reports in the literature for outpatient management of traumatic hyphemas in children. Therefore we studied such cases at our institutions.


METHODS
Retrospective chart review.


METHODS
25 children less than 16 years of age with grade I traumatic hyphemas.


METHODS
Inactivity at home with frequent office visits to monitor progress and complications. Treatment otherwise varied but virtually all patients received protective eye shields and topical steroids.


METHODS
Rate of rebleeding and final visual acuity.


RESULTS
Three patients (12%) suffered a rebleed; one required surgery for clot evacuation. One of the three did not receive topical steroids and if he is excluded, rebleed rate is 2/24 or 8.3%. The hyphema resolved without sequelae in the other 22 patients. All patients had a final visual acuity of 20/40 or better except three patients (12%) who had concurrent vision-limiting ocular injuries and/or disease. Final visual acuity was 20/30 or better in all three patients with rebleeds.


CONCLUSIONS
Our rebleed rate was within the broad range of rebleed rates reported in the literature. However, improved efforts to identify children at highest risk for rebleeding, to maximize compliance with treatments, and to consider systemic agents in selected cases, could further reduce the rebleed rate and increase acceptance and safety of outpatient management in pediatric traumatic hyphemas.
Coats
D K
DK
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. dcoats@bcm.tmc.edu
Viestenz
A
A
Paysse
E A
EA
Plager
D A
DA
D000293:Adolescent; D000553:Ambulatory Care; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001510:Bed Rest; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005131:Eye Injuries / Q000188:drug therapy* / Q000209:etiology; D005135:Eye Protective Devices; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006988:Hyphema / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage; D009883:Ophthalmic Solutions; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000188:drug therapy* / Q000209:etiology
D000933:Antifibrinolytic Agents; D005938:Glucocorticoids; D009184:Mydriatics; D009883:Ophthalmic Solutions