November 4, 1983

Treatment of Traumatic Hyphema

JAMA. 1983;250(17):2285. doi:10.1001/jama.1983.03340170023013

To the Editor.—  I read with concern Dr Yasuna's answer to the question, "Under what circumstances should one hospitalize patients with traumatic hyphema?" (1983;249:1207). The treatment of traumatic hyphema has always been controversial; however, most ophthalmologists would probably agree with Dr Yasuna that patients with severe hyphema should be hospitalized and perhaps those conditions of minimal hyphema (<10% of the anterior chamber involved) could be monitored daily on an outpatient basis. The purpose of hospitalization is to monitor for rebleeding and the development of increasing intraocular pressure, two of the feared complications of traumatic hyphema. It is by no means an accepted practice to include the administration of oral prednisone in the need for hospitalization, as suggested by Dr Yasuna.1The decision to treat a patient with oral steroid therapy with all of its well-known side effects, in the absence of a well-controlled, randomized, double-encoded study, is to be