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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/10/19 16:02:41」(JST)

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The eye is divided into a small front (anterior) segment, in front of the lens, and a large rear (posterior) segment, behind the lens. The anterior chamber is the light gray area at the top of this illustration.

Hyphema (or hyphaema, see spelling differences) is blood in the front (anterior) chamber of the eye. It may appear as a reddish tinge, or it may appear as a small pool of blood at the bottom of the iris or in the cornea.

Causes

Hyphemas are frequently caused by injury (blunt trauma) and may partially or completely block vision.

Presentation and prognosis

Hyphemas require urgent assessment by an ophthalmologist as they may result in permanent visual impairment.

A long-standing hyphema may result in hemosiderosis and heterochromia.[1] Blood accumulation may also cause an elevation of the intraocular pressure.

Treatment

Treatment of hyphema consists of 4 major tenets:

1. Light activity or even bedrest (to prevent a rebleed into the anterior chamber, which may cause obstruction of vision, or a painful rise in pressure)

2. Elevation of the head of the bed by approximately 45 degrees (so that the hyphema can settle out inferiorly and avoid obstruction of vision, as well as to facilitate resolution)

3. Wearing of an eye shield at night time (to prevent accidental rubbing of the eyes during sleep, which can precipitate a rebleed)

4. Avoidance of pain medications such as aspirin or ibuprofen (which thin the blood and increase the risk of a rebleed - instead, acetaminophen can be used for pain control).

It is controversial among ophthalmologists whether a steroid medication or a dilating drop (mydriatic) should be used in treatment of hyphema. Steroids aim to reduce the amount of inflammation, but are not without side effects. Dilating drops aim to increase comfort from the traumatized iris as well as reduce bleeding, but can also cause the pupil to be fixed in a dilated state via posterior synechiae (adhesions).

The vast majority of hyphemas resolve on their own without complication.

Some cases of non-resolving hyphemas, or hyphemas that are associated with high pressure, may require surgery to clean out the anterior chamber and prevent corneal blood staining.

External links

Hyphema - Handbook of Ocular Disease Management

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UpToDate Contents

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1. Traumatic hyphema: Management
2. 外傷性前房出血：臨床的特徴およびマネージメント traumatic hyphema clinical features and management
3. Traumatic hyphema: Clinical features and diagnosis
4. 視覚変化が認められた小児患者に対するアプローチ approach to the pediatric patient with vision change
5. 急性持続性視力喪失が認められた成人に対するアプローチ approach to the adult with acute persistent visual loss

English Journal

Supraciliary Micro-stent Implantation for Open-Angle Glaucoma Failing Topical Therapy: 1-Year Results of a Multicenter Study.

García-Feijoo J1, Rau M2, Grisanti S3, Grisanti S4, Höh H5, Erb C6, Guguchkova P7, Ahmed I8, Grabner G9, Reitsamer H9, Shaarawy T10, Ianchulev T11.
American journal of ophthalmology.Am J Ophthalmol.2015 Jun;159(6):1075-1081.e1. doi: 10.1016/j.ajo.2015.02.018. Epub 2015 Mar 3.
PURPOSE: To evaluate the safety and efficacy of a supraciliary micro-stent (CyPass Micro-Stent; Transcend Medical, Menlo Park, California, USA) for surgical treatment of glaucoma in patients refractory to topical medications.DESIGN: Multicenter, single-arm interventional study.METHODS: Patients with
PMID 25747677

Multimodal imaging for detection of clinically inapparent diffuse iris juvenile xanthogranuloma.

Samara WA, Khoo CT, Magrath G, Shields CL.
Journal of pediatric ophthalmology and strabismus.J Pediatr Ophthalmol Strabismus.2015 May 14;52:e30-3. doi: 10.3928/01913913-20150506-01.
A 6-month-old female infant was referred following three episodes of spontaneous hyphema. Iris juvenile xanthogranuloma was suspected but not clinically visible. Multimodal imaging with fluorescein angiography, anterior segment optical coherence tomography, and ultrasound biomicroscopy were used to
PMID 25992541

Exit strategies in canaloplasty: intraoperative conversion into 180-degree trabeculotomy or 360-degree trabeculotomy in cases of unsuccessful catheterisation of Schlemm's canal: influence of degree of canal cleavage.

Alnahrawy O1, Blumenstock G, Ziemssen F, Szurman P, Leitritz MA, Dimopoulos S, Voykov B.
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie.Graefes Arch Clin Exp Ophthalmol.2015 May;253(5):779-84. doi: 10.1007/s00417-015-2955-9. Epub 2015 Feb 18.
PURPOSE: To investigate the safety and efficacy of intraoperative conversion of unsuccessful canaloplasty technique into 180-degree metal or 360-degree suture trabeculotomy.METHODS: In this retrospective observational case series, 35 eyes of 35 patients with open-angle glaucoma (OAG) who had undergo
PMID 25690980

Japanese Journal

Bilateral hyphaema following diode laser for retinopathy of prematurity

RUNDLE P
Br J Ophthalmol 79, 1055-1056, 1995
NAID 30029649266

Spontaneous hyphaema associated with anterior uveitis

FONG DS
Br J Ophthalmol 77, 635-638, 1993
NAID 30029620017

Spontaneous hyphaema. Initial manifestation of lung carcinoma

SABBAGH R.
JAMA 266, 3194, 1991
NAID 30005352075

Related Pictures

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「前房出血」

Hyphema
	Classification and external resources
	; Hyphema - occupying half of anterior chamber of eye
ICD-10	H21.0
ICD-9	364.41
DiseasesDB	31299
MedlinePlus	001021
eMedicine	oph/765
MeSH	C11.290.484

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英: hyphema
ラ: hyphaema
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hyphaema