Incidence and clinical characteristics of pediatric traumatic hyphema from 2000 to 2009 in a population-based cohort.

PURPOSE: To provide updated epidemiologic data on pediatric traumatic hyphema.

METHODS

This multicenter retrospective, population-based cohort study included all patients <19 years of age diagnosed with a closed-globe traumatic hyphema from January 1, 2000, through December 31, 2009, in a single United States county.

RESULTS

During the 10-year study period, 70 patients (52 males [74%]) sustained a traumatic hyphema, yielding an incidence of 19 per 100,000 patients. Mean age at diagnosis was 13 years (range, 4.8-18.6). The most common injury mechanisms were sports (43%) and projectiles (23%). Mean logMAR visual acuity at presentation was 0.218 (range, 0.0 to light perception), and 14 patients (20%) had ocular hypertension during the first month post-injury. Microhyphema was present in 27 patients (44%), and 2 (3%) had a grade III hyphema or worse. Mean final logMAR visual acuity was 0.03 (range, -0.1 to 0.54). No patient had persistently elevated or asymmetric intraocular pressure. Long-term sequelae occurred in 29 patients (41%), most commonly angle abnormalities, but 27 (39%) did not undergo gonioscopy during the follow-up period.

CONCLUSIONS

The population-based incidence of traumatic hyphema is similar to that reported five decades ago. Expected visual recovery is good, although long-term sequelae are relatively common. The risk of ocular hypertension or glaucoma following traumatic hyphema is low through young adulthood, but one-third of patients did not receive gonioscopy following injury.