A hyphema is a pool of blood in the area between the iris, which is the colored part of your eye, and the cornea, which is the clear outer layer on the front of your eye. The blood can block light from reaching the back of your eye, or cause the pressure inside your eye to increase. Both of these can cause blurry vision.
If a hyphema is not treated, it can cause a permanent loss of vision.
What is the cause?
A hyphema is usually caused in one of two ways:
Injury to your eye
Medical problems such as diabetes, poor blood flow to your eye, and inflammation or tumors that cause abnormal blood vessels to bleed
What are the symptoms?
Symptoms may include:
Decreased vision or blurry vision
Eye pain or a feeling of pressure in your eye
Painful sensitivity to light
Blood pooled in the front of your iris
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and do exams and tests such as:
An exam using a microscope with a light attached, called a slit lamp, to look closely at the front and back of your eye
An exam using drops to enlarge, or dilate, your pupils and a light to look into the back of your eyes
An eye pressure test, which uses a small puff of air that is blown against your open eye or a device that briefly touches your eye to measure the pressure inside your eye
An ultrasound, which uses sound waves to show pictures of the back of your eye
Blood tests to check for sickle cell trait. People with sickle cell trait have an increased risk of high eye pressure and vision loss from hyphema.
How is it treated?
Most of the time, the blood will go away on its own. Often, your healthcare provider will tell you to:
Avoid bending and strenuous activity.
Rest in bed with your head raised on several pillows.
Wear an eye shield to protect your eye.
Use eye drops to decrease the swelling and irritation or lower pressure in your eye.
Avoid blood thinners like aspirin or ibuprofen. Do not stop taking these medicines unless your healthcare provider tells you to do so.
You may need surgery to help clear the blood from the front of your eye. You are more likely to need surgery if:
The blood fills the entire front of your eye.
You have sickle cell trait or sickle cell disease.
Your eye pressure stays high even with treatment.
The blood in the front of your eye starts to stain the cornea
Your eye bleeds again.
The risk for your eye bleeding again is highest in the first week after the bleeding started. If your eye does not bleed again, the hyphema will usually heal in one or two weeks, depending on how much blood is present.
How can I take care of myself?
Follow the full course of treatment your healthcare provider prescribes. Ask your healthcare provider:
How and when you will hear your test results
How long it will take to recover
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. You may be at risk for other eye conditions such as glaucoma because of the hyphema.
How can I prevent hyphema?
To help prevent severe eye injuries, wear safety eyewear when you:
Do any work around the house that requires hammering, power tools, chemicals, or splatter of any kind
Play paintball, racquetball, lacrosse, hockey, and fast-pitch softball
Shoot firearms or use explosives of any kind
Are in a high-risk area such as a construction site or shooting range
Wear a seatbelt to decrease injuries from car accidents.
Have regular eye exams, especially if you have a health condition such as diabetes.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-10-28 Last reviewed: 2014-10-28
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Blood in the Front of the Eye (Hyphema): References
American Academy of Ophthalmology. 2013-2014 Basic and Clinical Science Course. San Francisco: American Academy of Ophthalmology, 2013; v.1-13.