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You are seeing a 9 year old African-American child who was hit in the eye with a baseball. On exam there is visible blood layering in the anterior chamber, filling approximately 50% of the anterior chamber. There is no evidence of an open globe injury.
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June 13, 2023 at 12:44 pm
E) You would likely obtain all of these tests
The patient has traumatic hyphema. Blunt force trauma leads to blood vessel tears in the ciliary body or iris. Hyphema can also occur spontaneously in those with high-risk conditions such as bleeding dyscrasias. Patients with sickle cell anemia AND sickle cell trait are at higher risk for rebleeding and complications. IOP measurement should be done unless there are signs of an open globe injury (e.g. teardrop or abnormally shaped pupil, vitreous or uvea extrusion, Seidel’s sign). CT orbit may be needed with eye trauma to rule out other injuries such as orbital fracture. Ocular ultrasonography can also help assess for e.g. retinal detachment and intraocular pressure.