The Joys of Hyphema

[Patch101]

I like to play a lot of ball hockey, and I play on a lot of different levels (from fun to high level). Anyways, I was playing some hockey for fun with some friends in small gym. Luckily (I think), we use a taped up light wiffle ball on these night as opposite to the normal heavy orange ball.

So its Thursday, I ended up getting an errand ball from 5 feet away straight into the eye. After a minute of pain on the ground, I looked and saw nothing but red. I thought "oh ****, there goes my eye". Went to the bathroom, but other than being red looked ok. Decided to drive to the ER (with one eye, fun) and have it checked out. They took me in right away which was either good or bad. At this point I could see light, some movement, and colors. After being looked at, they tell me its a minor Hyphema and about 15% (blood) filled, and my pupil isn't doing anything. I get sent home, to see a specialist Saturday.

That night (Thursday still) I see a marked improvement by mid-night (3 hours afterwards) I can see things now from a 20 feet away. Not well, but I can see them now at least (feeling positive). Very light sensative, hurt to look at anything that had light. Hurts to look around in general.  

I sleep elevated that night, I wake up and I see another marked improvement. Through the day it continues to the point where I see quite well towards the end of the day as long as I stay still and didn't look around to much. If I did it was like kicking up a dust storm, and it would haze over. I'm also noticing that my pupil is now moving (not fully, but moving). Hurts to look around still.

Now its Saturday, wake up drive for a few hours to see this specialist. Today I needed pain meds, the eye really hurts to move around. I get there and he tells me, again. Minor Hyphema, 3 small tears that he can see. Gives me the dilating drops, as well as the milky inflammation drop.  Pressure is under 20 btw. No Retina problems or tears inside (good to hear). I notice my eye goes back to normal in at least 6 hours, and now I can focus up close again. Wife is driving (now dark) and I'm feeling good about my vision (car lights not bothering me a ton). I look at the eye before bed and the pupil is moving a lot more (but still not fully). The Haze isn't to bad at all (when still pretty clear) unless I'm doing a lot of moving around again. Light sensitivity is down to almost none. I was given 1% Cyclogyl to take once before bed for 3 days, and the inflammation drop to take regularly for a while. I'm told I can sleep in my bed, no elevation needed.

Its now Sunday, my vision seems very slightly worse today. Basically there seems to be more of a permanent haze that doesn't settle as easily as it did before when I was moving. Little concerned, but can't do nothing more than wait, and I feel like this might be from not sleeping elevated (little mad) Noticing lights have a bigger haze, kind of like the orange around them extends to a larger circle, difficult to explain. pupil is moving well, but not to the full range. I take the Dilating drop at mid-night, notice the pupil go huge.

Its now Monday, I slept elevated for most of the night, went to bed for the last hour. When I wake up at 8. Right eye very foggy, and the pupil is still huge (little concerned, why did it go away so quickly on Sat). Very light sensitive, and unable to see up close like before  (but this is the drops fault I know). Its now 12 noon, pupil still big, but the haze seems to have lifted somewhat from sitting here (which makes me feel better). Visually, I can only see a sliver of the blood left in my eye so it must be re-absorbing although it was pretty hard to see from the start. Moving the eye around feels good. That's where I'm at now.

I was very surprised the specialist gave me the ok to play hockey this Saturday. I thought I was not going to be able to make the Tourney, but it makes me feel like the injury isn't to bad.

Concerns right now are
1. when this hazing over will stop. Its frustrating to go from decent to hazzy whenever I go anything.
2. These dilating drops scare the crap out of me!

I thought I'd share my expierence, since my vision has been an expierence of bad to varing degree's of acceptable.  

[Patch101]

Called my specialist this morning, and they said I could discontinue the use of it as well.

They are now blaming the pupil on traumatic iritis, but considering it was working fairly well (not 100% I know), but better than this before I used the drop. When I mentioned that they said that it should return. Grrr.... guess all I can do it wait now and see if there is improvement.

[Patch101]

Absolutely John, I think for low level gym stuff I'll wear some glasses now, and at higher levels at the rink I already wore a helmet with a shield. I'll have to use a cage for the short term to insure total protection.

So its been 34 hours since I took my first drop of 1% Cyclogyl (was suppose to do this for 2 more nights), and the eye hasn't yet fully gone back to normal.

It has SLooooooowly been returning. It's maybe 50%, but still won't close fully to re-act with light (it is reacting to dark and opening). I called the pharmacist last night who told me to discontinue with the drop if hadn't returned to normal by this morning.

Using this stuff already scared me. At least my vision continues to improve daily. The Hazing effect from being still to moving feels less. Still have some light halo's and sensitivity to light, but not in a painful way. I feel like this is due to the Pupil situation though.

Whats the point of dilating the eye if it was moving well beforehand? is it to keep the clots from breaking? promote the blood absorption ?

[JohnHaganMD]

Okay but be sure you don't get a second hyphema, or retinal detachment. Wear eye protection.

JCHMD

[Patch101]

Maybe I'll have someone else look at it in 2 days. Get another opinion. I don't want to push my luck if its indeed not good.

[Patch101]

Yah, he mentioned not to do any sports till Saturday at the least, and then I repeated the question asking if I could indeed play on Saturday and he said it would be ok.

Saturday would make 10 days after the injury.

[JohnHaganMD]

That is not standard treatment and the peak risk of rebleed is 3 to 5 days after the initial injury. The re-bleed can be even larger than the original injury. I doubt very many ophthalmologists would turn you out unfettered to play again this soon especially since your vision is still blurry.

Suggest you get a second opinion.  Never play a ball or racquet sport again without full athletic eye protection.

JCH MD