Vitreous haemorrhage after cataract extraction.

One hundred eyes undergoing intracapsular cataract extraction and 100 undergoing extracapsular extraction were examined prospectively within one week postoperatively and again at 6-10 weeks postoperatively. Indirect ophthalmoscopy showed vitreous haemorrhage in 36% of the intracapsular group and 13% of the extracapsular group. Vitreous haemorrhage was significantly related to the occurrence of operative hyphaema (p less than 0.01) but not to iridectomy (p greater than 0.05). In the intracapsular group the use of chymotrypsin significantly reduced the incidence of vitreous haemorrhage (p less than 0.01). Three different types of vitreous haemorrhage were identified--streaks, diffuse haze, and beads in the vitreous base. Wound haemorrhage and operative hyphaema account for most cases, but it is suggested that zonular traction may be responsible for the bead haemorrhages and also for the retinal haemorrhages reported by other authors. Although no difference in visual result or incidence of cystoid macular oedema was observed in this study, a relationship to the vitreoretinal pathology of aphakia is suggested.

Blunt ocular trauma and hyphaema.

138 consecutive cases of traumatic hyphaema treated at Royal Perth Hospital were studied retrospectively. 47% of cases were caused by sporting injuries; 21% by squash alone. 105 cases were available for follow-up examination at 6 weeks. Using chi 2 distribution the finding of worse than 6/12 vision at follow-up was significantly related to the occurrence of major associated ocular injury, and also to the occurrence of secondary haemorrhage. The benefit of hospital admission is doubtful when compared to the cost. Modern therapeutic modalities including anti-fibrinolytics have improved the prognosis of secondary haemorrhage.