Every ophthalmologist who has attempted to treat traumatic hyphema realizes the challenge and potential danger of this serious condition. Frequently, an apparently minor injury to the globe causes severe hyphema with its associated complications and ominous prognosis.
That the solution to the perplexing problem of managing traumatic hyphema has not yet been found is emphasized by the multitude of therapeutic approaches to this enigma. Rychener in 1944 advocated the use of paracentesis only after an elevation of intraocular pressure following the occurrence of traumatic hyphema.1 Fralick who discussed this paper urged the early use of paracentesis before elevation of the pressure.1 This controversy of early versus late surgical intervention still exists. Another controversy concerning the treatment of traumatic hyphema revolves about the use of miotics or mydriatrics. This issue is not yet solved either, although currently most ophthalmologists refrain from using either medication unless a complication develops. Other
COLE JG, BYRON HM. Evaluation of 100 Eyes With Traumatic Hyphema: Intravenous Urea. Arch Ophthalmol. 1964;71(1):35-42. doi:10.1001/archopht.1964.00970010051006