What should be assessed in cases of hyphema?

• A. Observation only.
• B. Other eye trauma and consider a CT scan to assess the orbit.
• C. Only examine anterior chamber.
• D. Immediate intraocular surgery.

Answer: (B)

When hyphema occurs, it’s essential to look beyond the blood in the anterior chamber and assess for broader ocular and orbital injuries. A thorough exam should include evaluating for other eye trauma signs, globe integrity, and any mechanism suggestive of orbital involvement. Imaging is important when the history or exam raises concern for fractures, retrobulbar hemorrhage, or other orbital injuries; a CT scan of the orbits is the preferred study in acute trauma to rule out fractures or intraorbital problems that could change management.

This approach matters because some injuries won’t be visible just by looking at the front of the eye, yet they can drive treatment decisions and affect outcomes. Simply observing the hyphema or examining only the anterior chamber might miss these coexisting injuries. Immediate intraocular surgery is not routinely required unless there is a clear urgent indication (such as globe rupture); many cases are managed with protective measures, monitoring, and addressing intraocular pressure.