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Traumatic Hyphema in Children
Risk Factors for Complications
James C. Lai, MD;
Sharon Fekrat, MD;
Yolanda Barrón, MS;
Morton F. Goldberg, MD
Arch Ophthalmol. 2001;119:64-70.
Objective To identify risk factors associated with higher rates of ocular complications
in children with traumatic hyphema.
Methods Consecutive inpatient records from July 1990 through December 1997 were
retrospectively reviewed for all children (aged  18 years) who were admitted
to the Wilmer Ophthalmological Institute, Baltimore, Md, within 48 hours of
a closed-globe injury leading to hyphema. Data obtained included age, sex,
race, sickle cell status, initial and final visual acuities, hyphema size
and intraocular pressure at presentation, the occurrence of a secondary hemorrhage,
subsequent intraocular pressure elevations, and therapeutic interventions.
Results Forty children fulfilled the inclusion criteria: 20 African American,
1 Asian American, and 19 white. Five of the 20 African American children had
sickle cell trait, and 1 had sickle cell anemia. The rate of secondary hemorrhage
was statistically higher in the African American population (P = .05), but no statistical difference existed between the rate of
secondary hemorrhage in patients with and without sickle cell hemoglobinopathy.
Sickle cell hemoglobinopathy was associated with a higher intraocular pressure
at presentation (P = .03) and during inpatient follow-up
(P = .02).
Conclusions In the setting of traumatic hyphema, African American children appear
to be at greater risk for developing a secondary hemorrhage. In our patients,
sickle cell hemoglobinopathy increased the risk of intraocular pressure elevation,
but did not seem to increase the risk of rebleeding beyond that associated
with race. Larger studies are needed to validate these observations.
From the Wilmer Ophthalmological Institute, The Johns Hopkins Medical
Institutions, Baltimore, Md.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Risk Factors for Complications Following Traumatic Hyphema
Lai et al.
Arch Ophthalmol 2001;119:1732-1732.
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