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Spontaneous hyphaema requires a closer look

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Session Details

Session Title: Special Cases
Session Date/Time: Friday 26/02/2016 | 08:30-10:00
Paper Time: 09:24
Venue: MC3 Room
First Author: : R.Goetz IRELAND
Co Author(s): :    E. Cosgrave              

Abstract Details


To report four cases of spontaneous hyphaema that occurred secondary to iris microhaemangioma (IM) or Cobb's Haemangioma and discuss their clinical features, progression and importance.


All cases were patients who presented to the Ophthalmology Department of University Hospital Waterford, Waterford, Ireland.


A retrospective review was performed on four patients who presented to the ophthalmic emergency department of University Hospital Waterford, Ireland with spontaneous hyphaema.


All patients were found to have a Spontaneous Hyphaema with no neovascular cause or traumatic history. The pathophysiology was initially uncertain. On closer investigation, these patients were found to have rare Iris Microhaemangiomas (IM) or Cobb’s haemangiomas. They were all treated conservatively and made full recoveries. Though some reports recommend treating IM prior to intraocular surgery, one of these patients proceeded to have uncomplicated cataract surgery at a later date with no need for prior intervention.


These cases demonstrate how a rare condition can be missed if the ophthalmologist isn't thinking outside the normal scope of differential diagnoses. Due to the rare nature of IM, many ophthalmologists may not know of this disease or may mistake it for rubeosis; which leads to unnecessary examinations, FFAs and costly systemic workup investigations. Of the few cases in the literature, there is speculation that performing intraocular surgery on these patients carries an increased risk of intra-operative hyphaema. Although a reasonable assumption, one of our cases proceeded to have uncomplicated phacoemulsification without the need for prior treatment of their IM.

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