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Laura J Kopplin, Michael F Chiang, Daniel Karr; Outcomes Following Traumatic Hyphema in a Pediatric Population. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5483.
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Determine the visual outcomes and ocular comorbidities following post-traumatic blunt force hyphema in pediatric patients.
We conducted a retrospective chart review of patients evaluated at the Casey Eye Institute pediatric ophthalmology division between July 2008 and July 2013. We assessed presenting and final visual acuities, methods of injury, clinical management, ocular comorbidities and rates of complications including rebleed and intraocular pressure elevation.
We identified 49 patients diagnosed with hyphema, 36 of which occurred following blunt force, non-penetrating ocular trauma and were examined further. The average patient age was 9.1±3.4 years. The majority of subjects were male (80.6%). Presenting visual acuities ranged from 20/20 to light perception. Small projectiles (airsoft pellets, BBs, paintballs) and sports related injuries were the most common mechanisms of trauma, occurring in 15 patients (41.6%). No patients required admission for treatment, although all were instructed to significantly limit home activity. The most frequent concomitant injury was corneal abrasion (44.4%). Re-bleeding occurred in four subjects (11.1%); despite this complication, these subjects all eventually obtained 20/30 or better vision. Eight (22.2%) subjects required treatment with intraocular pressure lowering medications, although none remained on these medications beyond the end of follow up. One subject underwent anterior chamber washout. We examined patients that established follow up for at least one visit (32 patients, 88.9%) to determine best corrected final visual acuities; all had 20/30 acuity or better.
There is good potential for visual recovery following uncomplicated traumatic hyphema in a pediatric population. Outpatient management of traumatic hyphema was not associated with decreased vision from re-bleeding.
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