Hyphema — Why Is There Blood in My Eye?

The term hyphema denotes the accumulation of blood in the anterior (front) chamber of the eye, the fluid-filled space between the cornea and the iris.

Hyphemas can vary in appearance. A hyphema may be no more than a tiny spot—invisible in the mirror—or it may be severe enough to completely obscure vision in the affected eye.

What Symptoms Will Develop If I Have Hyphema?

Mild cases of hyphema are not always visible to the naked eye, but total hyphema can actually block the view of the iris and pupil. Symptoms may vary, depending on the cause of the bleeding, but may include blurred vision, severe eye pain, and extreme sensitivity to light.

Why Does Hyphema Occur?

The most common cause of blood in the eye is trauma, which can take the form of blunt trauma, laceration, or abrasion. Other possible causes of eye bleeding include:

• Cancer
• Abnormality in a blood vessel
• Iris inflammation
• Diabetes
• Certain blood diseases, such as sickle cell anemia
• Retinal vein occlusion
• Anterior uveitis
• Eye surgery

What Are The Complications of Hyphema?

While the complications that may accompany bleeding in the eye vary, depending on the cause, the condition itself can damage the cornea, and can lead to high intraocular pressure and possibly glaucoma if not managed correctly.

What Are My Treatment Options for Hyphema?

Due to the potentially serious nature of any eye problem that causes bleeding, hyphema should always be treated as a medical emergency, and an immediate visit to an optometrist or ophthalmologist is warranted.

Diagnosis of the cause of bleeding in the eye will require a doctor to conduct a thorough eye exam, which may include dilation, a slit lamp examination, and measuring the intraocular pressure.

Your doctor may recommend that you wear an eye patch and take a few days’ bed rest, sleeping with your head elevated so as to not disrupt the blood that is settled. Depending on the severity, a cycloplegic drop (a dilation drop that lasts several days) may be prescribed if there is severe pain accompanying the hyphema.

Steroidal eye drops may be prescribed to reduce inflammation, and you will be advised not to take aspirin or ibuprofen.

In more severe cases, however, surgery may be necessary in order to drain the blood and clear any blockage that may have developed in the eye’s drainage system.

How Can I Prevent Blood in my Eye?

The best way to prevent hyphema is to guard yourself against injury to the eye. When participating in any sport, always wear protective goggles (in addition to whatever other protective gear is standard for your sport). If you wear glasses, always make sure to take them off before engaging in any kind of rough play or risky physical activity.

If you are having eye pain or any sort of vision problems, be sure to report them to your primary doctor, who will probably refer you to an optometrist or ophthalmologist.

Talking to Your Doctor

Here are some questions to ask your doctor about hyphema:

• How severe is the injury to my eye?
• (If there is no obvious injury to the eye) What is the cause of the bleeding in my eye?
• Is it possible I could suffer from permanent visual impairment?
• Am I suffering from ocular hypertension?
• Is it possible that my hyphema was caused by my recent eye surgery?