{"id":3549,"date":"2026-06-26T18:21:58","date_gmt":"2026-06-26T16:21:58","guid":{"rendered":"https:\/\/www.first-sight.ch\/?post_type=glossary&#038;p=3549"},"modified":"2026-06-26T18:22:26","modified_gmt":"2026-06-26T16:22:26","slug":"hyphema-bleeding-in-the-anterior-chamber","status":"publish","type":"glossary","link":"https:\/\/www.first-sight.ch\/en\/glossar\/hyphema-bleeding-in-the-anterior-chamber\/","title":{"rendered":"Hyphema (Bleeding in the Anterior Chamber)"},"content":{"rendered":"<p>A hyphema is a collection of blood in the anterior chamber of the eye \u2013 the space between the cornea and the iris. It is a serious eye injury that must be treated by an ophthalmologist immediately to prevent lasting damage.<\/p>\n<h2>Causes<\/h2>\n<p>The most common cause is a blunt injury to the eye \u2013 for example from a ball, an elbow, or a fall. Other possible causes are:<\/p>\n<ul>\n<li><strong>Eye injuries during sports:<\/strong> especially ball sports without protective glasses<\/li>\n<li><strong>Following eye surgery:<\/strong> as a complication after intraocular procedures<\/li>\n<li><strong>Abnormal blood vessels:<\/strong> in certain eye diseases (e.g. neovascularization in diabetes or after vascular occlusions)<\/li>\n<li><strong>Blood clotting disorders:<\/strong> congenital or medication-related clotting disorders increase the risk<\/li>\n<li><strong>Sickle cell anemia:<\/strong> patients with sickle cell disease have an increased risk of serious complications from a hyphema<\/li>\n<\/ul>\n<h2>Symptoms<\/h2>\n<ul>\n<li>Visible collection of blood in the eye (a reddish layer in front of the iris, especially when sitting upright)<\/li>\n<li>Blurred vision or deterioration of vision<\/li>\n<li>Eye pain<\/li>\n<li>Light sensitivity<\/li>\n<li>In severe hyphema: the entire eye appears dark red<\/li>\n<\/ul>\n<h2>Grades of severity<\/h2>\n<ul>\n<li><strong>Grade I:<\/strong> blood fills less than one third of the anterior chamber<\/li>\n<li><strong>Grade II:<\/strong> one third to half of the anterior chamber is filled<\/li>\n<li><strong>Grade III:<\/strong> more than half of the anterior chamber is filled with blood<\/li>\n<li><strong>Grade IV (total hyphema \/ \"eight-ball\"):<\/strong> the entire anterior chamber is filled with blood and appears black<\/li>\n<\/ul>\n<h2>Treatment<\/h2>\n<p>The treatment aims to prevent further bleeding and to control the intraocular pressure:<\/p>\n<ul>\n<li><strong>Rest with the upper body elevated:<\/strong> the head is raised (30\u201345 degrees) so that the blood settles at the bottom of the anterior chamber and impairs vision less.<\/li>\n<li><strong>Eye protection:<\/strong> a shield (not an eye patch) protects the eye from further blows.<\/li>\n<li><strong>Cortisone eye drops:<\/strong> to reduce inflammation.<\/li>\n<li><strong>Pupil-dilating drops (mydriatics):<\/strong> keep the iris still and relieve pain.<\/li>\n<li><strong>Avoiding aspirin and ibuprofen:<\/strong> these medications inhibit blood clotting and increase the risk of rebleeding. If pain medication is needed, paracetamol (acetaminophen) is the safer choice.<\/li>\n<li><strong>Pressure-lowering eye drops:<\/strong> if the intraocular pressure is raised.<\/li>\n<li><strong>Surgery:<\/strong> in severe cases \u2013 such as blood that does not clear, very high intraocular pressure, or impending corneal damage \u2013 the blood can be removed surgically.<\/li>\n<\/ul>\n<h2>Rebleeding<\/h2>\n<p>In the first 3\u20135 days after the initial injury, there is a risk of renewed bleeding (rebleeding), which is often heavier than the first. For this reason, physical rest and regular check-ups are particularly important during this phase.<\/p>\n<h2>Possible complications<\/h2>\n<ul>\n<li><strong>Raised intraocular pressure:<\/strong> the blood can block the outflow of aqueous humor and cause secondary glaucoma.<\/li>\n<li><strong>Corneal blood staining:<\/strong> prolonged contact with blood can discolor the cornea.<\/li>\n<li><strong>Long-term glaucoma risk:<\/strong> even after healing, the intraocular pressure should be checked regularly in the following years.<\/li>\n<\/ul>\n<h2>Prevention<\/h2>\n<p>Many hyphema cases in children and adolescents can be avoided by wearing sports protective glasses with polycarbonate lenses \u2013 especially during ball sports and other high-risk activities.<\/p>","protected":false},"excerpt":{"rendered":"<p>A hyphema is a collection of blood in the anterior chamber of the eye \u2013 the space between the cornea and the iris. It is a serious eye injury that must be treated by an ophthalmologist immediately to prevent lasting damage. Causes The most common cause is a blunt injury to the eye \u2013 for 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