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

ABSTRACT

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 71. 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