|Case of the Week - Patient Summary 7336|
Peer Reviewed and Certified -
|Demographics: 48 y.o. Woman|
|History & Chief complaint:|
| History of uveitis 25 years ago. Red eye, photophobia, irritation onset 2 weeks ago. |
|Physical exam and Laboratory:|
| The uveitis caused a posterior synechiae which led to a hyphema upon breaking the synechiae. |
|Summary of Findings:|
|The anterior segment images show pigment on the anterior surface of the lens and the resultant hyphema after the posterior synechiae were broken.|
| Recurrent uveitis with hyphema |
|Posterior synechiae are adhesions of the posterior surface of the iris to the anterior surface of the lens capsule. These adhesions can form during an episode of acute anterior uveitis. Extravasation of fibrin into the anterior chamber causes the initial adhesion, and fibrovascular organization of the adhesion is seen later. Extensive posterior synechiae may obstruct aqueous flow through the pupil, causing an anterior bowing of the iris known as iris bombй. Mydriatic agents may be used to break the adhesions.
Hyphema refers to the accumulation of free blood in the anterior chamber. The most common cause of hyphema is blunt trauma, but it may also occur perioperatively or spontaneously. Hyphema has also been reported as a complication of uveitis. Management of hyphema consists of IOP control and prevention of rebleed.