Hyphema (Blood in Eye) in Dogs


Hyphema is described as a condition in which there is presence of blood in front (anterior chamber) of the eye. The presence of Hyphema could be an indication of trauma, an eye injury, internal eye and systemic conditions and some serious underlying diseases.

This can result from bleeding from the blood vessels of the eyes (iris, choroid, retina, ciliary body), scarring of the conjunctiva, tissues surrounding the eye and eyelids. It can be unilateral (affecting one eye) or bilateral (affecting both the eyes). Mild Hyphema appears as a pink to light red coloration of the fluid discharge, whereas chronic or severe Hyphema results in prominent visible blood in the eye and can put pets at an increased risk of developing Glaucoma (High Blood Pressure in the eye).

Causes

Presence of blood in the front of the eye can be resulted from
› Trauma, Physical injury, accidents, scarring of the eye or tissues surrounding the eye, Chocking
› Eyelid disorders
› Inflammation of the Ciliary body, Choroid tissues and Iris
› Inflammation of the blood vessels in the eye
› Ocular conditions such as Uveitis (Inflammation of the inner structures of the eye), Proptosis, Retinal Dysplasia, Glaucoma, Retinal Detachment
› Tumors, Ulcers, Abrasions
› Cancer and Leukemia
› Hypertension (High Blood Pressure)
› Hyperthyroidism
› Systemic deficiencies
› Chronic Kidney disease
› Reactions to known drugs and medicines
› Poisoning and Toxicity caused from accidental ingestion of insecticides, rodenticides, disinfectants, chemicals
› Chronic Liver disease
› Vitamin K deficiency
› Blood clotting disorders such as Hemophilia, Von Willebrand’s Disease
› Thrombocytopenia, platelet dysfunction
› Hyperviscosity syndrome
› Tick borne diseases such as Ehrlichiosis, Rocky Mountain Spotted Fever (RMSF)

Clinical Signs & Symptoms

Common symptoms include:
› Presence of blood in the eye
› Redness in the eye
› Blood clotting in the eye
› Corneal scarring / bruising
› Inflammation of the eye tissues
› Keeping eyelids closed
› Uveitis (Inflammation of the Inner Pigmented Structure of the Eye)
› Recurrent Ocular Discharges
› Squinting
› Pawing / rubbing the eyes
› Eye Pain
› Decreased Vision
› Blindness (Loss of Vision)
› Blood staining on areas surrounding the eyes

Diagnosis

Veterinarians will require a complete history of your dog which includes medical history, vaccination records, existing health concerns, current and previous medications, onset of symptoms, diet and exercise routine and any information which can help in establishing a correct diagnosis. Diagnosis is done with a combination of tests. These include routine lab examinations and special tests. They are:

› Physical Examination
› Eye Examination
› Schirmer Tear Test (STT)
› Fluorescein Stain
› Tonometry Test
› Ultrasound
› Gonioscopy

Other tests include:
› Complete Blood Count (CBC) including a platelet count
› Biochemical Profile
› Urinalysis (UA)
› Radiographs (X-Rays) in-case of systemic illness
› Serum Biochemical Tests to evaluate serum levels in protein
› Blood Pressure (BP) Test
› Coagulation Tests
› Thyroid Test
› Chest Radiograph (X-ray)
› Abdominal Radiograph (X-rays)
› Bone Marrow Aspirate for bone cancer

Treatment

Treatment depends on the causes and the severity. It aims at treating the underlying cause and reduce inflammation. This includes:
› Medications for treatment of underlying cause
› Oral medications (to lower eye pressure)
› Topical ointments, drops (as directed)
› Anti-inflammatory medications
› Surgery in-case of accidents, trauma, physical injury, tumors and lesions

Prevention

Hyphema is not a disease but a symptom arising from other known diseases and conditions. Early detection and treatment of underlying causes will reduce the chances of problems arising from Hyphema.

Home Care

Home care should aim at improving the condition. Treatments depends on the underlying cause. Most cases resolve within a week. Post surgery treatment, Sutures are typically removed within 14 days. If you observe any behavioral changes, or if the condition does not improve, please contact your veterinarian.

Prognosis is always good post surgery. Most pets are treated on an outpatient basis.

› It is mandatory to provide a stress-free environment for your dog. Keep water and food bowls within reach. Avoid physical activity. Keep your dogs away from any noise and commotions.
› You have to administer and monitor all prescribed medicine as directed by your veterinarian.
› Do NOT travel with your dog.
› Do not allow your dog to roam outdoors
› Always keep sharp objects covered and fragile objects away from pets to avoid the risk of injury and accidents.
› Routine and regular checkups to access the progress, further tests may be advised to check for infections.
› Exercise caution when dealing with pets. Daily cleaning and vacuuming, disposal of materials such as bandages, cotton swabs used for abscess or by ear secretions. Wear gloves and wash your hands thoroughly. Using disinfectants and proper hygiene protocols are strongly advised.
› Always keep sharp objects covered and fragile objects away from pets to avoid the risk of injury and accidents.

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