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...
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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.

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