A Cat Suffering from Hyphema

Hyphema in Cats

Hyphema is the presence of blood within the front (anterior) chamber of the eye and is a symptom of either a serious ophthalmic disease or systemic disease. The amount of blood within the front chamber can vary. Mild hyphema may appear only as a pinkish-red discoloration to the fluid in the front of the eye, or as red blood settled out on the bottom of the chamber. Severe hyphema is when the entire chamber is filled with blood and the animal is rendered blind.

Hyphema usually originates from bleeding of the iris blood vessels, but the blood may also originate from the ciliary body (tissue behind the iris), choroidal blood vessels (tissue layer beneath the retina), or retinal blood vessels.

Below is an overview of Hyphema in Cats followed by detailed information about the diagnosis and treatment options for this disease.

Hyphema in Cats

Many cats have some level of decreased vision the affected eye(s); however, if only one eye is involved, their behavior is usually normal. Eyes with hyphema may be painful, with symptoms of squinting, increased blinking and tearing. Trauma-induced hyphema is often accompanied by hemorrhages or bruising of the conjunctiva and tissues around the eye.

Bleeding that is extensive or recurrent may completely fill the anterior chamber, resulting in total hyphema and blindness. Eyes with severe hyphema are at increased risk for developing glaucoma (elevated pressure within the eye) and must be monitored closely for this potential complication.

Initially, the color of the blood within the eye appears bright red. The blood may remain unclotted and settle on the floor of the eye. The blood may also clot and turn dark brown or bluish-black with time.

The presence of hyphema can either be a symptom of a serious eye disease or a manifestation of some internal problem elsewhere in the body. While hyphema is often caused by trauma to the eye, spontaneous hyphema may occur with numerous different ocular and systemic disorders. Therefore, it is imperative that the cause of the hyphema be identified immediately.

Prognosis for vision depends on whether the hyphema is mild or severe, whether the pupil can be effectively dilated during treatment, and whether there is bleeding or damage in the back of the eye as well. The presence of severe hyphema, failure to dilate the pupil, hemorrhages in the back of the eye or retinal detachment often results in blindness.

Causes of Hyphema in Cats

In general, the causes of hyphema fall into one of several categories:

More Potential Causes of Hyphema in Cats

Diagnosing Hyphema in Cats

A complete medical history is obtained and a thorough physical examination performed. Be sure to tell your veterinarian if you are aware of any potential exposure to toxins or poisons, of any head or eye trauma, the time and rate of onset of the bleeding (sudden or slowly progressive), medications currently being given, ongoing medical conditions or recently observed physical abnormalities of your pet.

A complete ophthalmic examination usually includes examination of the interior of the eye under magnification, staining of the cornea with fluorescein, and tonometry to detect glaucoma. It is important to determine the extent of the hyphema, whether it is confined to the anterior chamber, whether the posterior part of the eye is also involved, and if the condition exists in one or both eyes. Your veterinarian may refer your cat to a veterinary ophthalmologist for further evaluation of the hyphema using specialized instrumentation.

Complete blood count (CBC) including a platelet count are performed to look for evidence of infection/inflammation, and to ensure there are adequate numbers of platelets present. Then, a serum biochemistry panel is run to evaluate organ functions and measure protein levels in the serum.

Your veterinarian or veterinary ophthalmologist may recommend further diagnostic tests to search for other conditions in the body or to evaluate how much damage is present in the eye. Some commonly performed additional tests include:

More Information on Treatment of Hyphema in Cats

The goals of therapy of hyphema are two-fold. It is intended to both treat the inflammation that arises in the eye from the bleeding and to treat any underlying causes of the bleeding.

Treatment of the hyphema itself involves the following: