Document Type
Article
Publication Date
9-26-2022
Abstract
Purpose: Hyphema is a sequela of ocular trauma and can be associated with significant morbidity. Management of this condition is variable and can depend on individual institutional guidelines. We aimed to summarize current practices in hyphema management across ophthalmological institutions worldwide.
Methods: A cross-sectional online survey was conducted across North America, Asia, South America, Africa, Europe, and Australia from August 2020 to January 2021. The survey assessed the existing practices in the management of hyphema at each institution.
Results: For layered hyphema, topical steroids were routinely administered by 34 (of 36 respondents, 94.4%) institutions, of which prednisolone was the preferred choice (n = 32, 88.9%). Topical cycloplegics were used at 34 (94.4%) institutions. No institution reported routine use of antifibrinolytics. Head elevation was the most deployed procedure to promote hyphema reabsorption (n = 31, 86.3%), followed by partial bed rest (n = 21, 58.3%). The majority of institutions (n = 25, 69.4%) did not routinely pursue admission for hyphema patients, although 75.0% of institutions (n = 27) scheduled follow-up visits within 48 hours of presentation. Additionally, few institutions performed routine sickle cell trait testing for patients presenting with hyphema (n = 6, 16.7%). The decision to perform anterior chamber washout varied and was often based on intraocular pressure and the speed of hyphema resolution.
Conclusion: Unanimity of international institutions on hyphema management is lacking. As it stands, many current interventions have unconvincing evidence supporting their use. Evidence-based guidelines would be beneficial in guiding decision-making on hyphema management. Additionally, areas of consensus can be used as foundations for future standard of care investigations.
Recommended Citation
Miller, Sarah C; Meeralakshmi, Prajna; Fliotsos, Michael J; Justin, Grant A; Yonekawa, Yoshihiro; Chen, Ariel; Hoskin, Annette K; Blanch, Richard J; Cavuoto, Kara M; Low, Rebecca; Li, Ximin; Gardiner, Matthew; Liu, T Y Alvin; Shah, Ankoor S; Auran, James D; Agrawal, Rupesh; Woreta, Fasika A; and International Globe and Adnexal Trauma Epidemiology Study (IGATES), "Global Current Practice Patterns for the Management of Hyphema" (2022). Wills Eye Hospital Papers. Paper 164.
https://jdc.jefferson.edu/willsfp/164
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
PubMed ID
36187914
Language
English
Comments
This article is the author’s final published version in Clinical Ophthalmology, Volume 16, September 2022, Pages 3135 - 3144.
The published version is available at https://doi.org/10.2147/OPTH.S372273. Copyright © Miller et al.