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Purpose: To report the electron microscopic findings on an explanted intraocular lens in a patient with the uveitis, glaucoma, hyphaema syndrome., Methods: Scanning and transmission electron microscopy were undertaken on a coccoon of cellular material from the tip of the intraocular lens haptic., Results: Scanning electron micrographs showed densely packed coccoid-like structures on the haptic surface. By transmission electron microscopy these structures proved to be melanosomes., Conclusions: The scanning electron micrographs described in this report are similar to those reported in patients with chronic post-operative uveitis, but to our knowledge have not been shown before in association with the uveitis, glaucoma, hyphaema syndrome. Transmission electron microscopy determined that the coccoid-like structures were melanosomes. The melanosomes are probably derived from damaged pigment epithelial cells or iris stromal melanocytes secondary to recurrent chafing of the haptic against the posterior surface of the iris.

A retrospective study of the visual outcome of 425 in-patients with traumatic hyphaema has been conducted. A multivariate analysis demonstrated that after adjusting for age, sex and pre-existing poor vision, the size of hyphaema on presentation and the presence of retinal damage were significant predictors of a worse final visual outcome (p = 0.00003 and 0.00001 respectively). Topical steroid and/or cycloplegic medication, and the occurrence of secondary haemorrhage did not influence the final visual outcome after adjustment for the other variables. These data illustrate, in an unselected sequential population of patients, the role of these factors in terms of final visual outcome following hyphaema from blunt ocular trauma.

In a retrospective study of 462 in-patients with traumatic hyphema, secondary haemorrhage occurred in 8.7% of patients. A multivariate analysis demonstrated that the size of hyphaema on presentation and the presence of retinal damage did not affect the probability of secondary haemorrhage. The incidence of secondary haemorrhage was found to decrease by approximately half with the use of topical steroid (p = 0.005), but did not appear to be influenced by the use of cycloplegics. These data indicate in an unselected sequential population of patients, the therapeutic importance of topical steroid in the treatment of blunt ocular trauma.