• Franco M Recchia, Raminder K Saluja, Krista Hammel, and John B Jeffers.
• Ocular Trauma Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
• Ophthalmology. 2002 Aug 1;109(8):1465-70; discussion 1470-1.

ObjectiveThis study was performed to evaluate the clinical course of patients treated for traumatic microhyphema and the occurrence of elevated intraocular pressure (IOP) and secondary hemorrhage in these patients.DesignRetrospective noncomparative case series.ParticipantsRecords of all patients treated for traumatic microhyphema through the Wills Eye Hospital Emergency Department from January 1997 through September 1999 were analyzed retrospectively. Patients examined for 3 consecutive days after presentation and 2 weeks after initial presentation were included. Patients with open-globe injury were excluded. A total of 162 patients met the study criteria.InterventionAll patients were treated initially as outpatients according to the standard Wills Eye Hospital protocol for traumatic microhyphema (atropinization, bedrest, shield, restriction of antiplatelet medications). Three patients were subsequently hospitalized.Main Outcome MeasuresThe occurrence of IOP elevation (greater than 21 mmHg) and rebleeding was recorded. The effect of topical corticosteroids was evaluated.ResultsIOP was elevated in 14 patients. Six patients had IOP less than 26 mmHg and required no treatment. Six patients had IOP greater than 26 mmHg and received medical treatment. In two patients, IOP increased after initial presentation. Of 150 patients with normal IOP at presentation, only one (0.7%) developed an elevated IOP at any point to warrant treatment (28 mmHg). Rebleeding was documented in three patients, one of whom developed a layered hyphema. The incidence of rebleeding was not statistically associated with the use of topical corticosteroids.ConclusionsComplications from traumatic microhyphema treated with standard measures are few. Closeness of follow-up may be determined by IOP on presentation. Secondary hemorrhage seems to be unaffected by the use of topical corticosteroids.

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