Hyphema that develops months or years after uncomplicated cataract extraction is a clinical entity resulting from focal vascularization of the limbal wound. Vessels from the episclera may penetrate the wound, terminating in capillaries that are the source of bleeding. Sudden blurring of vision sometimes following minimal trauma is the primary symptom. The bleeding, initially, is minimal and occurs only periodically; therefore, it is easily overlooked. Gonioscopic examinations may reveal the bleeding site in the inner lips of the incision. Accumulation of blood in the lower angle leads to angle-closure glaucoma. The most effective therapy to control the bleeding remains to be established. Surgical excision of the neovascularized area and argon-laser coagulation seem to be promising therapies.
Swan KC. Hyphema Due to Wound Vascularization After Cataract Extraction. Arch Ophthalmol. 1973;89(2):87-90. doi:10.1001/archopht.1973.01000040089001