Outpatient management of traumatic hyphema in children: prospective evaluation.
OBJECTIVE
To evaluate the clinical outcome of children with traumatic hyphema treated on an outpatient basis.


METHODS
A prospective cases series. Thirty-five children with traumatic hyphema were treated as outpatients for the ocular injury from February 2002 to February 2003. Data regarding initial and final visual acuity, slit-lamp biomicroscopy, hyphema size,ophthalmoscopy, intraocular pressure, rebleeding, clearance time, and medical and surgical intervention were recorded.


RESULTS
Thirty (85.7%) children were male, and the major cause of traumatic hyphema was domestic tools (14 cases, 40.0%). Twenty-four patients (68.6%) presented low grades of hyphema. Seventeen patients (48.6%) had intraocular pressures higher than 24 mm Hg. The most common lesions associated with traumatic hyphema were corneal injuries (16 cases, 45.7%). The median final visual acuity was 20/25. Unsatisfactory final visual acuity (worse than 20/30) was statistically associated with ocular posterior segment lesions (P = 0.009) and grade of hyphema (P = 0.004). The grade of hyphema was also related to intraocular hypertension (P = 0.018) and time for hemorrhage absorption (P < 0.001). Nine patients (25.7%) underwent surgical intervention. Rebleeding occurred in three patients (8.6%).


CONCLUSIONS
Outpatient management is a feasible option for children with hyphema. Associated posterior ocular segment injuries and hyphema of greater magnitude were related to the worst final visual acuities.
Department of Ophthalmology, Federal University of São Paulo, Brazil.
Karolinne Maia
KM
Rocha
Elisabeth Nogueira
EN
Martins
Luiz Alberto S
LA
Melo
Nilva Simeren Bueno de
NS
Moraes
D000293:Adolescent; D000553:Ambulatory Care / Q000379:methods*; D000556:Ambulatory Surgical Procedures; D000869:Anterior Eye Segment / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000145:classification / Q000601:surgery*; D005260:Female; D006801:Humans; D006988:Hyphema / Q000145:classification / Q000601:surgery*; D007429:Intraocular Pressure; D008297:Male; D009887:Ophthalmoscopy; D011446:Prospective Studies; D012008:Recurrence; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000601:surgery*