Hyphema in Dogs

These sudden types of hyphema may be caused by many things such as glaucoma, retinal tears, or uveitis. There are several different ways this disorder may present itself such as tiny blood clots in the eye, a redness of the entire eye, or several layers of recurrent hyphema which shows as purple and bright red areas. Hyphema may be just an annoyance or a severe debilitating condition, depending on the cause and severity. Some of the secondary complications are adhesions, permanent blurred vision, and blindness.

Even if your dog’s eye is only a little bit red and does not seem to be painful or affecting vision, it could be a sign of an underlying disorder. For example, your pet may have high blood pressure or a clotting disease such as Von Willebrand’s Disease, hemophilia, or thrombocytopenia. If your dog has blood or discoloration in the eye, you should see a veterinary professional as soon as possible to prevent serious complications.

Hyphema is a hemorrhage in the eye between the cornea and the iris that causes the area to fill with blood. This condition usually occurs because of an injury but may happen spontaneously.

The symptoms of hyphema are varied, depending on the cause. However, some of the most common are:

• Redness in the eye
• Cloudiness of the eye
• Pool of blood in the iris or cornea
• Squinting (blepharospasm)
• Eye pain
• Keeping eye closed
• Vision loss (bumping into objects)

Types

• Traumatic hyphema is a condition caused by an injury to the head or eye
• Secondary hyphema may be caused by many different diseases and disorders

• Trauma
• Uveitis (inflammation of the eye)
• Intraocular neoplasia (tumor)
• Retinal detachments or tears
• Systemic hypertension (high blood pressure)
• Coagulation factor abnormalities
• Platelet disorders such as leukemia, anemia, lymphoma, and blood loss.
• Hyperviscosity
• Congenital ocular anomalies
• Anterior segment neovascularization
• Glaucoma
• Lungworm
• Rat poison ingestion

It is important to have your pet checked out by your veterinarian as soon as possible if you suspect hyphema because it could be a sign of a secondary condition that may be  serious. In fact, it may be an early symptom of an illness that could be life threatening, so it is best to get it checked out. The veterinarian will need to discuss your dog’s medical history and recent vaccination records. Be sure to let the veterinarian know if you have given your pet any medication or supplements of late because some products can mimic or mask symptoms and affect the treatment plan.

A comprehensive physical examination will be done including checking your dog's reflexes, pupil reaction time, mucous membrane color, blood pressure, respirations, and breath sounds. In addition, the veterinarian will do a detailed optical assessment and run some diagnostic tests. Some of these tests will include a fluorescein stain test, tonometry, ocular ultrasound, Schirmer tear testing, cytology, x-rays, and slit lamp examination. Laboratory tests may include a urinalysis, fungal and bacterial cultures, and additional blood marker evaluation to investigate secondary causes.

The treatment depends on what is causing the hyphema and how severe it is. For example, if your dog had an eye injury and there are no other complications, there may be no need to treat the eye because it will go away on its own. For other causes of hyphema, the underlying problem has to be treated.

Ulceration

Treatment usually includes antibiotic drops, topical atropine, and oral non-steroidal anti-inflammatory drugs (NSAIDS). Your dog may need to wear a cone to prevent rubbing. If there is an underlying cause of the ulceration, such as Dry Eye, this will need to be treated as well.

Glaucoma

To treat glaucoma, prostaglandin, mannitol, and carbonic anhydrase inhibitor may be prescribed. Surgical options include laser cyclophotocoagulation, anterior shunts, evisceration, or enucleation.

Uveitis

Topical atropine, prednisone drops, NSAIDs, or systemic steroid cream may be used.

Intraocular Neoplasia (tumor)

In this case, the tumor will need to be removed, which typically means enucleation of the eye. Other treatments, such as chemotherapy or radiation, may be used in some situations.

Systemic Hypertension

If your dog is found to have high blood pressure, beta blockers or ACE inhibitors may be prescribed. The veterinarian will also want to look into the cause of the hypertension.

Other Causes

Other causes of hyphema will require further examination and possibly a visit to a specialist. Your veterinarian will refer you to who you need to see.

After treatment, you may need to keep your pet in a crate or a small room to prevent accidents. Exercise will be limited; each case will be individually assessed as to when to return to normal activity. In some instances, eye drops or medicated ointment will be required on a daily basis during the recovery period or longer. Return for follow up must always be adhered to, per the veterinary team’s recommendations.