Ultrasonographic abnormalities in eyes with traumatic hyphema obscuring intraocular structures: 33 cases (1991-2002)

Objective: To examine ultrasonographic abnormalities in eyes with traumatic hyphema obscuring intraocular structures. Design: Retrospective clinical study. Setting: The ophthalmology services of a private practice and university veterinary teaching hospital. Animals: Twenty-two dogs, 6 cats, 3 horses, and 2 birds. Measurements and main results: Medical records were reviewed for signalment, history, ophthalmic examination, ultrasonographic findings, treatment, and outcome in all patients that presented to the ophthalmology service with trauma-induced hyphema obscuring intraocular structures. Thirty-three patients were included and there were 35 affected eyes (17 left and 18 right). Abnormalities noted on ophthalmic examination included hyphema obscuring intraocular details beyond the iris (100%), corneal laceration (23%), iris prolapse (23%), fibrin clotting within the anterior chamber (17%), and subconjunctival and periocular bruising (17%). Ocular ultrasonography revealed the presence of either vitreous hemorrhage or a retinal detachment in 32 of 35 eyes (91%) with traumatic hyphema. Of the remaining 3 eyes, ocular ultrasonography revealed a lens luxation with posterior eye wall rupture in 1 eye and collapsed globes in the other 2 eyes. Twelve eyes were enucleated and 23 were treated medically. Ten of the medically treated eyes were lost to follow-up. Blindness was noted in all the affected eyes upon their final discharge and recheck examination. Conclusions: Ocular ultrasonography revealed vitreous hemorrhage or a retinal detachment in 32 eyes (91%) with traumatic hyphema. Blindness was noted on the last available examination of every eye. The prognosis for vision in an eye with traumatic hyphema obscuring intraocular detail is poor.