Treatment of traumatic hyphaema - abstract

ABSTRACT

Fifty-three (53) patients who sustained hyphaema after blunt trauma were admitted, treated and followed up in the Eye Department, at the Queen Elizabeth Hospital, Barbados. Many forms of treatment are used for patients with traumatic hyphaema. These range from no medication to mydriatics, miotics, tropical and systemic corticosteroids and systemic aminocaproic acid. Several studies in the past suggest that both aminocaproic acid and systemic steroids were successful in reducing the incidence of rebleeding. However, the rate of rebleeding is so variable that controversy exists about the necessity of treatment. In this study, all patients were treated with topical corticosteroids, no mydriatics and strict bed rest. Seven per cent (7.5 percent) of the patients experienced rebleeding; however, rebleeding was not a determining factor related to the final outcome of visual acuity. The adverse reactions of aminocaproic acid and systemic steroids greatly outweigh the benefits of their usefulness in reducing the incidence of rebleeding in our situation. The treatment regime consists of strict bed rest, topical corticosteroids (to treat the masked Iritis) and no mydriatics (to prevent further aggravation of sphincter damage). Raised intraocular pressure is a major concern following traumatic hyphaema and requires early recognition and prompt management (AU)