What is the role of gonioscopy in the workup of hyphema?

Updated: Jan 18, 2019
  • Author: David L Nash, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
  • Print
Answer

Answer

Examination of the angle structures is critical to understanding the extent of the blunt trauma precipitating a hyphema. This can be delayed until after the critical 5-day, high-risk, re-bleed period.  In particular, dynamic gonioscopy should be avoided in the acute phase. Angle abnormalities, synechiae, and recession may commonly be found. Rarely, a focus of bleeding can be photocoagulated with the argon laser on low-power settings, up to 300 mW with a 200-µm spot size. All patients with hyphema due to blunt trauma should undergo gonioscopy once the hyphema has cleared to rule out angle recession.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!