Is topical corticosteroid necessary in traumatic hyphema?

PURPOSE: To compare the outcomes in the management of traumatic hyphema treated with topical corticosteroid plus supportive therapy versus only supportive therapy. PATIENTS AND METHODS: In this retrospective study, 206 patients were divided into two groups; group I, 98 eyes were treated with topical corticosteroid 12 × 1 and supportive therapy including bed rest, keeping the head elevated (45 degrees), and hydration. In group II, 108 eyes were treated with only supportive therapy. Hyphema size, initial and final visual acuities and intraocular pressure, time to hyphema clearance, and incidence of rebleeding were evaluated. RESULTS: The time needed for hyphema resorption in the two groups were 60.25 ± 33.9 and 62.3 ± 28.9 hours respectively (P=0.62). There was no significant difference in rebleeding rate between the topical corticosteroid group (4.01%) and non-steroid group (6.48%) (P=0.67). The initial and final visual acuities were similar in the two groups (P=0.86). In Groups I and II, the average intraocular pressures were 19.7 ± 8.01 and 14.2 ± 10.2 mmHg respectively. The difference between the two groups was statistically significant (P=0.04). CONCLUSION: Patients who were treated with topical corticosteroids were no less likely to experience a rebleed or a poor visual outcome than those treated with supportive therapy alone. Supportive therapy alone may be convenient and cost-effective management strategy in uncomplicated traumatic hyphema.

Pattern of ocular trauma in Kuching, Malaysia

Objectives: To analyze the causes and characteristics of ocular injuries presenting to Sarawak General Hospital (SGH), Kuching. Design: It is a prospective hospital-based study done for a period of 1 year. Setting: Department of Ophthalmology, Sarawak General Hospital, Malaysia. Participants: All ocular injury patients seen for the first time in the Eye Department during the period January 2006 to December 2006 were included in the study. Eye injury patients on follow-up and treated elsewhere were excluded. Results: A total of 233 patients, and 257 eyes, were studied. Men had six-fold higher rates of injury than women. The average age of presentation was 30 years. The predominant age group was between 21-30 years, 26.2 % (n=61). Eye injuries related to work were seen in 36.9% of patients. There was a gross negligence in the use of personal protective devices in the work-related group. The common settings in which the injuries occurred included home 34.3% (n=80) and industrial premises 31.8% (n=74). Assault-related injuries 7.7% (n=18) were seen mostly among young men in the age between 20-30 years. The initial presenting visual acuity of the patients with blunt ocular trauma was better than penetrating injury. Conclusion: Ocular injuries were common in young males. Work related eye injuries were noted in a significant number of cases. Health education and preventive strategies both in the working place and at home will help to decrease the occurrence of ocular injuries.