Hyphema is the presence of blood in the anterior chamber of the eye. It is an ocular finding that is most often associated with trauma to the involved eye. However, spontaneous and secondary hyphema must be considered, as their causes are more varied. Spontaneous hyphema can be due to neovascularization, such as diabetes, ischemia, and cicatrix formation, ocular neoplasms, such as retinoblastoma and medulloepithelioma, and vascular anomalies, such as juvenile xanthogranuloma. Systemic blood disorders such as sickle cell anemia, hemophilia, and Von Willebrand disease can also produce spontaneous hyphemas. Most patients present with pain, blurred or lost vision, photophobia, and tearing. Glaucoma, both acute and long-term late-onset as well as optic atrophy, can occur with hyphema.
ICD10CM: H21.00 – Hyphema, unspecified eye
SNOMEDCT: 75229002 – Hyphema
Differential Diagnosis & Pitfalls
There really is no differential diagnosis for hyphema; what matters most is the cause, since that governs workup and treatment. Therefore, one must not only take a careful and complete history but also perform a careful physical exam that includes both slit lamp and ophthalmoscopic exam.
Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.