Outpatient management of traumatic microhyphema.
OBJECTIVE
This study was performed to evaluate the clinical course of patients treated for traumatic microhyphema and the occurrence of elevated intraocular pressure (IOP) and secondary hemorrhage in these patients.


METHODS
Retrospective noncomparative case series.


METHODS
Records of all patients treated for traumatic microhyphema through the Wills Eye Hospital Emergency Department from January 1997 through September 1999 were analyzed retrospectively. Patients examined for 3 consecutive days after presentation and 2 weeks after initial presentation were included. Patients with open-globe injury were excluded. A total of 162 patients met the study criteria.


METHODS
All patients were treated initially as outpatients according to the standard Wills Eye Hospital protocol for traumatic microhyphema (atropinization, bedrest, shield, restriction of antiplatelet medications). Three patients were subsequently hospitalized.


METHODS
The occurrence of IOP elevation (greater than 21 mmHg) and rebleeding was recorded. The effect of topical corticosteroids was evaluated.


RESULTS
IOP was elevated in 14 patients. Six patients had IOP less than 26 mmHg and required no treatment. Six patients had IOP greater than 26 mmHg and received medical treatment. In two patients, IOP increased after initial presentation. Of 150 patients with normal IOP at presentation, only one (0.7%) developed an elevated IOP at any point to warrant treatment (28 mmHg). Rebleeding was documented in three patients, one of whom developed a layered hyphema. The incidence of rebleeding was not statistically associated with the use of topical corticosteroids.


CONCLUSIONS
Complications from traumatic microhyphema treated with standard measures are few. Closeness of follow-up may be determined by IOP on presentation. Secondary hemorrhage seems to be unaffected by the use of topical corticosteroids.
Recchia
Franco M
FM
Ocular Trauma Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
Saluja
Raminder K
RK
Hammel
Krista
K
Jeffers
John B
JB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D000869:Anterior Eye Segment / Q000293:injuries* / Q000473:pathology; D001285:Atropine / Q000627:therapeutic use; D001510:Bed Rest; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000209:etiology / Q000628:therapy*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006988:Hyphema / Q000209:etiology / Q000628:therapy*; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D009798:Ocular Hypertension / Q000209:etiology / Q000628:therapy; D017410:Practice Guidelines as Topic; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000209:etiology / Q000628:therapy*
D005938:Glucocorticoids; D001285:Atropine