Whoa There Is Blood In The Eye!

Dr. Kisling Emergency Fort Collins Optometrist Contact, glaucoma, Uncategorized, Wilderness Medicine Eyes Leave a Comment

Blood In The Eye

Sometimes you step of the beaten trail and get a little far away from home and medical care. Especially in states like Colorado, people spend a lot of time in remote locations outdoors. Hyphema, or blood in the anterior chamber of the eye, is one of those situations you hopefully won’t be faced with in a remote location. But just in case!

Hyphema-Blood Inside The Eye Wilderness Medicine Injury

Hyphema-Blood Inside The Eye

Hyphema Is Normally A Result Of Eye Trauma

A blow to the eye can cause bleeding from the iris or the base of the iris. The iris is the colored tissue you see that causes your eyes to be a beautiful brown or blue (and in this case red eyes! Typically you would not see an eye half full of blood as pictured here. More often it will appear as a much smaller section occupying 1/3 or less of the height, and below the lower pupil margin. Gravity is forcing the red blood cells to settle, giving the straight top line with the blood in the inferior half of the eye. The blood is actually filling up the space between the iris and the cornea. The cornea is the clear tissue that covers the iris and ends where the white of the eye begins. The eye has a rim of bone surrounding it to protect it from just this type of trauma, but sometimes a fist (find a new friend) or rock is smaller than the orbit and sends a shock wave through the fluid of the eye, similar to a tsunami. This abrupt wave of pressure damages the blood vessels in the iris.

Bleeding Eyes-What To Do When You Are In The Wilderness

Most cases of hyphema will resolve with little effects on vision long term. A minor hyphema will probably dissipate in about a week as the blood is reabsorbed. Bed rest and keeping the head elevated at 30 degrees is the recommended treatment. Don’t worry too much about 30 degrees, just keep the head a little elevated to help keep the blood settling downward like the picture. Avoid aspirin, ibuprofen, and anything that will increase the probability of bleeding. Tylenol is the preferred remedy for pain from other injuries like the black eye that may have accompanied the hyphema.

When To Worry

If you are with someone who has sickle cell disease they are at increased risk of re-bleeding and complications from an eye injury that results in hyphema. Larger hyphemas are associated with a greater risk of complications, so be more concerned if the fill level inside the eye is more than 25 to 30%. Glaucoma can occur from the cellular debris and proteins clogging the drainage of the eye. Fortunately this happens only 1-2 percent of the time. Rebleeding and hemorrhages in the eye are the precipitating event for most severe complications. Smaller hyphemas can probably walk out without too  much of an increase in risk to the eyes. If the eye is over half full and/or there is a history of sickle cell or other bleeding disorders you might want to consider a more urgent evacuation. There is a prescription drug called Amicar (Aminocaproic acid) that may improve outcomes in some cases if used early enough. Other prescription eye drops may be needed if glaucoma develops. Well over 90% of hyphemas will resolve in a week or so so odds are in your favor for good visual outcomes!

THE ABOVE INFORMATION SHOULD NOT BE USED AS MEDICAL OR TREATMENT ADVICE AND IS INTENDED ONLY FOR EDUCATIONAL PURPOSES. ALWAYS SEEK THE ADVISE OF A MEDICAL PROFESSIONAL AND USE ADVISED PROTOCOLS IN  TREATING ANY INJURIES. KNOWLEDGE AND TREATMENTS CHANGE AT A RAPID PACE AND ANY INFORMATION MAY BE DATED.

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