Visual acuity recovery following traumatic hyphema in a pediatric population

PURPOSE To determine the rate of visual recovery following hyphema caused by traumatic blunt force injury in children. METHODS The medical records of patients evaluated between July 2008 and July 2014 were reviewed retrospectively. Primary outcome measures included presenting and follow-up visual acuities. RESULTS At total of 56 eyes of 55 children (<18 years of age) were diagnosed with hyphema following blunt force nonpenetrating injury. The average patient age was 10.3 +/- 3.2 years. The majority of subjects were male (78%). Presenting visual acuities ranged from logMAR 0.0 (Snellen equivalent, 20/20) to light perception. Rebleeding occurred in 4 subjects (7.1%). Visual acuity demonstrated improvement over the first 28 days following injury, with 59% achieving visual acuity of logMAR 0.0 (Snellen equivalent, 20/20) and 82% recovering vision to logMAR 0.2 (Snellen equivalent 20/30) by day 28. All but 1 patient (43 of 44 eyes, 98%) had a best-corrected visual acuity of better than or equal to logMAR 0.2 at their last recorded follow-up. CONCLUSIONS There is good potential for visual recovery following uncomplicated traumatic hyphema in children. In our patient cohort, the majority of patients had significant improvement in visual acuity within the first 28 days; in some children visual acuity continued to improve beyond the first month.