Traumatic Hyphaema Grading
Graded by % of anterior chamber filled with blood after blunt trauma. Higher grade predicts secondary haemorrhage (rebleed at 2–5 days), elevated IOP, and corneal blood-staining.
Score interpretation
→ Ophthalmology referral same-day if blunt trauma. Daily review × 5 days. Topical cycloplegic (atropine 1% TDS), topical steroid (prednisolone QDS). Head elevation 30°. Restrict activity. Avoid aspirin/NSAIDs. Sickle-cell screen in at-risk groups.
→ Admit for monitoring (especially children). Daily IOP and visual acuity. Topical regime as above + oral tranexamic acid 25 mg/kg TDS if rebleed risk high. Oral antifibrinolytic only if no contraindication and NOT in sickle disease.
→ Admit. Risk of acute IOP rise (especially sickle), corneal blood staining (>5 days IOP >25), and optic atrophy. Anti-glaucoma drops + oral acetazolamide; avoid CAIs in sickle. AC washout indicated if: IOP >50 for 5 days, IOP >35 for 7 days, total hyphaema >5 days, or corneal blood staining. Always exclude open-globe injury.
Interpretation bands for the Hyphaema. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Retinol palmitate with white soft paraffin, light liquid paraffin, liquid paraffin and wool fat · Ocular lubricant ointment
- Yellow soft paraffin · Emollient / Ocular lubricant
- Dexamethasone 0.1% Eye Drops (Maxidex) · Topical corticosteroid (ocular anti-inflammatory)
- Proxymetacaine 0.5% Eye Drops (Minims Proxymetacaine) · Topical ocular anaesthetic
- Sodium Hyaluronate 0.1% Eye Drops (Hylo-Forte) · Ocular lubricant (viscous eye drop — dry eye disease)
- Acute Red Eye / Vision Loss Screen · RCOphth 2020; NICE CKS
- Idiopathic Intracranial Hypertension · ABN; consensus 2018
- Acute Red Eye Assessment · RCOphth / AAO
- Acute Angle Closure Glaucoma · RCOphth / EGS Guidelines
- Retinal Detachment · RCOphth Guidelines / EURETINA
- Diabetic Retinopathy — Screening and Management · NICE NG28 2016 / NHS DES Programme
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.