Epidemiological profil of post contusive hyphaema experience of the paediatric ophthalmology department of Casablanca

Abstract

Aims/Purpose: Hyphaema is defined as the presence of blood in the anterior chamber. It occurs after a contusive or perforating ocular trauma or in the aftermath of ocular surgery. The aim of our work is to analyse the clinical, therapeutic and evolutionary profile of post‐contusive hyphaema.Methods: A retrospective study was conducted on 66 children (33 eyes) admitted to the ophthalmologic emergency room for post‐contusive hyphaema followed and treated in the paediatric ophthalmology department of the 20 August hospital in Casablanca between January 2015 and January 2023.Results: There was a male predominance with 67% of boys affected. The average age was 9.5 years. The main cause of consultation was visual acuity (VA) loss in 49%. On examination, the initial VA was <1/10 in 38% of cases, the ocular tone was >20 in 30% of cases. Hyphaema was classified as stage I in 26.4%, stage II in 52%, stage III in 15.2%, stage IV in 6.4%. Post‐traumatic cataract was present in 50% of the cases, lens dislocation in 22% of the cases, angle recession in 6%. Intravitreal haemorrhage was present in 2 patients, berlin oedema in 3 patients. The treatment prescribed in all patients was strict rest, abundant drinks, oral and local corticotherapy and dilatation with atropine. In addition, a hypotonizing treatment was prescribed for the patients who presented an ocular hypertonia. The evolution was marked by the total resorption of the hyphaema in 90% of the cases. Surgical treatment (hyphaema lavage) in 10% of cases. The final VA was >6/10 in 60% of cases. The most serious complication was haematocornea in 6% of cases.Conclusions: Frequent and serious condition in children that can jeopardize the functional prognosis of the eye. When the diagnosis is made, the management must be early in order to avoid complications.