Management of non-penetrating traumatic hyphema in ophthalmology department of HMC. Review of 83 cases

To review the management strategy of non-penetrating traumatic hyphema in ophthalmology department of HMC [Hamad Medical Corporation] and compare it with other international approaches. This is a retrospective study for evaluating the management of non-penetrating traumatic hyphema in the Ophthalmology Department of Hamad Medical Corporation. Records of 83 patients over the period between January 1999 and May 2003 were studied for various criteria including: demographic factors; causes; severity and type of hyphema; visual and intraocular pressure outcome; and application and outcome of medical and surgical treatment. Patients' criteria and treatment policy was compared with other studies.Visual acuity as defined according to the WHO system. Total of 83 patients; 76% males and 24% females, their average age was 24.4 years. The majority had hyphema due to work trauma 45.8%, 76% recovered 6/12 or better vision within one month, 14% developed glaucoma, 2.4% complicated by corneal blood staining. Mydriatics were used in 65%, 5% had rebleeding. All the patients were treated as inpatients, only one case required surgical intervention for uncontrolled IOP and early corneal staining. Dependent on the findings of our study and other studies, we rationalized alterations to be concerned according to Qatar locality, however, the general outcome of traumatic hyphema in our department was not bad

Hifema traumático: estudio de 5 años / Traumatic hyphema: a five-year study

Se presentan los resultados de un estudio clinicoestadístico de una serie de 80 pacientes hospitalizados en nuestro servicio con el diagnóstico de hifema traumático e integridad del globo ocular, en el período comprendido entre enero de 1983 y diciembre de 1987. La mayor incidencia de hifema traumático ocurrió en pacientes jóvenes con edades inferiores a los 26 años, con amplio predominio del sexo masculino; en el 50 % de los enfermos trabajadores, la lesión ocular fue producida por un accidente de trabajo. Se reconocieron lesiones traumáticas asociadas en el 85 % de los casos. El 10 % de los hifemas fueron totales, y se encontró una relación positiva entre el tiempo de resolución del hifema y su volumen. Finalmente, en relación con los resultados terapéuticos, se destaca como aspecto positivo los índices satisfactorios de recuperación visual y es significativo el tanto de enfermos (66,6 %) que recuperaron la normalidad de la visión

Ophthalmic uses of tissue plasminogen activator

Tissue plasminogen activator [tPA] is a protease enzyme which catalyzes the conversion of plasminogen to plasmin. It is synthesized in vivo by human vascular endothelial cells and has also been manufactured in vitro, using recombinant DNA technology. Experimental and clinical investigations have been performed evaluating the efficacy of tPA in the treatment of different ophthalmologic disorders. Use of tPA has proven beneficial in the treatment of selected cases of hyphema, postoperative fibrin formation, and subretinal hemorrhage. Toxicity studies have demonstrated that 25 micro g of intraocular tPA is safe in nonvitrectomized eyes. We present a review of the literature with regard to the use of tPA

Incidence and prognosis of concessive hyphema in northwest frontier province of Pakistan

Sixty-three consecutive cases of concussive traumatic hyphema admitted to the Department of Ophthalmology, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from May 1987 to July 1988 were studied prospectively. Majority of the patients [61.9%] were under the age of 15, and male to female ratio was 7:1. Eye Injury mostly occurred during sports, while at play, by flying objects such as stones, mudballs and goli dandas. Only a little over one half of the patients, 35 [55.6%], sought medical attention within 24 hours. Twenty-seven [42.9%] patients had total hyphema. Recurrent hyphema occurred in 12 [19.0%] patients, and nine of these had delayed presentation. Glaucoma, corneal staining, necessity of surgical intervention, and poor visual outcome often accompanied recurrent hyphema. Of the 36 patients with known final visual acuity, 12 [33.3%] had a visual acuity of 20/200 [6/60] in the affected eye. These figures are much higher than the figures reported from the developed countries, despite the fact that in the developing countries the incidence of hyphema in more or less similar to that of our study. The reason for delayed presentation, higher number of total hyphemas, and poor visual outcome are poverty, illiteracy, poor public awareness, and a lack of eye care facilities in the rural areas of Pakistan. An aggressive public health education and implementation of sound epidemiological principals are needed to improve the situation