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—Dr Witteman's data on traumatic hyphema are welcome and important. His suggestion that northern Europeans (and their descendents) have relatively low rebleed rates has intrigued me also, and it is possible that a true racial effect may exist. Other factors, such as severity of the trauma, associated damage to ocular structures, socioeconomic status, use of antiplatelet agents such as aspirin, and so on, may also influence the occurrence of this serious complication. In addition to the Scandinavian references cited, in Dr Witteman's letter, a current Swedish article reports a zero rate of secondary hemorrhage following traumatic hyphema.1 Conversely, North American reports frequently show rebleed rates of 16% to 37%. (For reviews on this subject, see Gilbert and Jensen2 and Wilson.3) This higher rate of secondary hemorrhages has also been true of three separate studies done in the University of Illinois Eye and Ear Infirmary during
Goldberg MF. Traumatic Hyphema-Reply. Arch Ophthalmol. 1984;102(3):357-358. doi:10.1001/archopht.1984.01040030276014