### Description

Hyphema, or bleeding into the anterior chamber (AC) of the eye, may occur after trauma. The risk of secondary bleeding can be predicted if the status of 4 risk factors is known. This can help decide whether or not to treat prophylactically, with those at high risk likely to benefit.

Risk Factor

Finding

Odds Ratio from Multivariate Logistic Regression Analysis

visual acuity

20/200 or less

2.4 (1.0 - 5.8)

hyphema grade at presentation

Grades 2, 3, 4

1.9 (0.6 - 5.7)

delay in treatment

> 1 day

2.7 (1.0 - 7.5)

intraocular pressure at presentation

>= 21 mm Hg

2.9 (1.1 - 7.6)

from Table 3, page 1586

where:

• Visual acuity is described in the paper using ">=" and "<=". These do not appear to be consistently used in Figures 2, Table 3 and Table 6.

Extent of Bleeding

less than one third of the anterior chamber (AC)

1

one third to one half of the AC

2

one half to three quarters of the AC

3

more than three quarters of the AC

4

defined page 1584

number of risk factors =

= SUM(number of findings present)

Interpretation:

• If no risk factors are present, then the risk of secondary hemorrhage is 5%.

• If at least one risk factor is present, then the risk of secondary hemorrhage is 2-3 times greater..

 Visual Acuity Grade Delay Pressure Risk of Secondary Bleeding 20/100 or better 1 <= 1 day < 21 mm Hg 5% 1 <= 1 day >= 21 mm Hg 12% 1 > 1 day < 21 mm Hg 11% 1 > 1 day >= 21 mm Hg 27% >= 2 <= 1 day < 21 mm Hg 8% >= 2 <= 1 day >= 21 mm Hg 21% >= 2 > 1 day < 21 mm Hg 20% >= 2 > 1 day >= 21 mm Hg 42% 20/200 or less 1 <= 1 day < 21 mm Hg 11% 1 <= 1 day >= 21 mm Hg 26% 1 > 1 day < 21 mm Hg 24% 1 > 1 day >= 21 mm Hg 48% >= 2 <= 1 day < 21 mm Hg 18% >= 2 <= 1 day >= 21 mm Hg 40% >= 2 > 1 day < 21 mm Hg 40% >= 2 > 1 day >= 21 mm Hg 64%

after Table 6, page 1588

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