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Hyphaema (bleeding in eye)

An accident, sports injury or trauma to the eye can cause bleeding in the eye called hyphaema.

The bleeding is in the front compartment or anterior chamber of the eye between the clear cornea and the coloured iris.

A person with a hyphaema may feel pain in the injured eye, and may have blurred vision.

If the hyphaema is large, the eye itself may look as if it is filled with blood. Smaller hyphaemas are not always visible.

When to seek medical care

Any hyphaema needs urgent medical attention. You can call your GP for an urgent appointment or you can go straight to your local general hospital A&E. The eye (ophthalmology) departments in most large NHS general hospitals have a dedicated Accident and Emergency department for eye injuries.

If you cannot see your GP quickly, go to a hospital's A&E department.

Examinations and tests

If you see an ophthalmologist (eye specialist), he or she will ask about any history of eye injury, when the injury may have happened, and how it happened. It is important for the ophthalmologist to know if, for example, you were hit in the eye with a bat or you ran into a low-hanging branch of a tree.

  • A complete eye examination is performed.
  • A visual acuity test checks for how well you can see. The intraocular pressure (pressure inside the eye) must be checked.
  • A special microscope, called a slit lamp, is used to look inside the structures of the eye.
    • A hyphaema can be seen as a clot or layered blood in the anterior chamber of the eye. If the entire anterior chamber is filled with blood, it is sometimes referred to as a “black ball” hyphaema. Smaller hyphaemas may appear layered in the anterior chamber.
    • A micro-hyphaema may also be seen. This appears as a haziness of suspended red blood cells in the anterior chamber.
  • If you have experienced severe trauma, the doctor may arrange X-rays or a CT scan to look at the eye sockets themselves and other facial structures, and to exclude the presence of any debris or a foreign body in or around the eye.
  • People of African and Mediterranean descent should be screened for sickle cell disease or thalassaemia, which can lead to serious complications. In these cases, surgery may be considered as an early option.

Hyphaema treatment - self-care at home

Hyphaema should not be treated at home without first seeing a doctor. Don’t attempt to cover the eye, because, if done incorrectly, you may do more harm than good.

Medical treatment

Treatment of hyphaema depends on how readily you comply with instructions. It’s important to follow medical advice. About 15-20% of people with a hyphaema have further bleeding in 3-5 days. This is why compliance with advice is so important.

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