What is the role of topical medications in the treatment of traumatic hyphema?

Updated: Jan 18, 2019
  • Author: David L Nash, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Various topical medications have been recommended for treating patients with traumatic hyphema, including cycloplegics for traumatic iridocyclitis and miotics to increase the surface area of the iris to enhance resorption of the hyphema. [21, 37, 38] Topical corticosteroids and estrogens [38, 39] have been recommended with contradictory results. [39]

Investigations conducted by the authors of patients with traumatic hyphema excluded the use of topical medications because of a lack of definite evidence of their advantages. [6, 27] One recommendation regarding topical medication is that the topical use of steroids after the third day or the fourth day of retained hyphema may be advantageous to decrease the associated iridocyclitis and to prevent or deter the development of peripheral anterior synechiae or posterior synechiae. Secondly, topical atropine (1%) is indicated in hyphemas occupying more than 50% of the anterior chamber to reduce the incidence of posterior synechiae formation and avoid pupillary block.

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