STEP2: EYES

Question 1

is blood in the anterior chamber of the eye caused by disruption of blood vessels in the ciliary body and/or iris.

Answer 1

Hyphema

Question 2

Visible blood in the anterior chamber
Ciliary flush
Nonspecific symptoms: pain, photophobia, blurred vision

Answer 2

Hyphema

Traumatic hyphema (most common)
Spontaneous hyphema may result from:
Coagulopathies
Neovascularization of the iris
Sudden change in IOP

Question 3

Answer 3

Hyphema

Traumatic hyphema (most common)
Spontaneous hyphema may result from:
Coagulopathies
Neovascularization of the iris
Sudden change in IOP

Question 4

a collection of blood between the conjunctiva and the sclera

Painless red focal lesion visible against the sclera
Signs and symptoms of traumatic eye injury
Changes in visual acuity, photophobia, eye pain, foreign body sensation
Bullous SCH: elevated hemorrhage indicates underlying severe intraocular injury (e.g., scleral laceration)

Answer 4

subconjunctival hemorrhage

Transiently increased venous pressure (the most common cause of spontaneous SCH) due to, e.g., Valsalva maneuver, coughing, vomiting
Traumatic eye injury: blunt ocular trauma, contact lens use (more common in adults < 40 years)
Hypertension (most common cause in elderly individuals)
Diabetes mellitus
Coagulopathy
Fat embolism (e.g., in the context of long-bone fractures)
Antiplatelet and anticoagulation therapy
Vaginal delivery is a common cause of SCH in neonates
Ocular surgery
Tumors of the conjunctiva (e.g., cavernous hemangioma, lymphangioma)