Critical Cases - Traumatic Hyphema!


  • 55 year old male struck with unknown object in a bar fight
  • He was found down for an unknown amount of time
  • He denies pain or vision changes

Physical Exam



  • Note the red (blood) in the anterior chamber
  • The complete filling of the anterior chamber is known as an "8 ball hyphema"
  • IOP is measured at 15 mm Hg bilaterally
  • Fluorescin stain is negative


  • Elevate head of bed
  • Consider globe rupture and place eye shield
  • Monitor IOP
  • Manage elevated IOP as per acute angle closure glaucoma - clotted blood clogs the trabecular meshwork and prevents drainage of aqueous humor
  • Emergent opthalmology consult