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Erschienen in:
01.06.2014 | Clinical Image
The Eight-Ball Eyeball: Grade IV Hyphema
Erschienen in: Journal of General Internal Medicine | Ausgabe 6/2014
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A 31-year-old woman presented with left eye pain and vision loss after being hit in the eye by a cigarette lighter. Exam revealed a globe protrusion encased by conjunctiva at the inferior limbus (Fig. 1), elevated intraocular pressures (IOP) (> 50 mmHg), and grade IV hyphema. Computed tomography (CT) scan confirmed anterior globe rupture (Fig. 2). She received an alpha agonist, a beta blocker, steroids, cycloplegics, and a carbonic anhydrase inhibitor before undergoing open globe repair.1,2
Figure 1
External eye examination. The cornea appeared completely black (blue arrow) after the initial injury. The anterior rupture (red arrow) appeared two weeks later and prompted the patient to come to the emergency room. The protrusion occurred inferior to the corneal limbus and contained blood, clot, uveal tissue and aqueous humor.
Figure 2
Sagittal view of CT scan showing area of anterior rupture encased by a thin layer of overlying conjunctiva (red arrow). This area corresponds to the protrusion seen at the inferior limbus of the left eye in Figure 1. The lighter layer surrounding globe (blue arrow) is the sclera (yellow arrow). The whitish area behind the protrusion represents the lens (green arrow).
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