Clinical Presentation and Visual Outcome in Patients with Traumatic Hyphaema: A Study in A Public Medical College Hospital

Abstract

Introduction: Accumulation of blood in the anterior chamber of eye due to trauma is called traumatic hyphaema. Eye injuries still remain one of the most common causes of unilateral blindness worldwide. The presence of hyphaema is a sign of major intraocular injury and its management poses a challenge to the ophthalmologist if it is associated with other ocular injuries
as there is risk of potential long-term complication. Purpose: To find out various clinical presentation of traumatic hyphaema and observe different management approaches to it and its visual outcome. Methods:It was a cross sectional retrospective study of the patients having traumatic hyphaema admitted at Sher-E-Bangla Medical College and Hospital, Barishal between June 2019 and December 2020. Clinical data included visual acuity on admission, final VA at 3 months, slit lamp evaluation with grading of hyphaema, intraocular pressure and fundus findings. For the purpose of recording, a proforma was prepared containing patients name, age, sex, occupation, address, chief complaints, history of present as well as past ocular and systemic illness, family history, and treatment history. Preform also contained findings of pre-treatment ocular examinations, response to treatment, complication, visual outcome, etc. Results: The mean age was 24.23 years, with males showing a preponderance, the ratio being 4.57:1. The most common mechanism of injury was impact by projectile objects 33.33%. The mean visual acuity at presentation was 6/60 and at 3 months improved to 6/18. Posterior segment injuries were associated with a worse visual outcome. A total of 58.97% of patients presented with a grade-1 hyphaema. Conclusion: Traumatic hyphaema is a recognized cause of significant visual morbidity. Improved visual acuity was attained after 3 months. The presenting visual acuity correlated with the visual prognosis. Patient with posterior segment complications tended to have poorer visual outcomes; grade of hyphaema, initial VA, cause and onset of injury were also other significant factors.