Spontaneous Hyphema in Infancy and Childhood

Abstract

Spontaneous hyphema in childhood, particularly in infancy, is commonly attributed to juvenile xanthogranuloma of the iris. The purpose of this report is to describe other causes of spontaneous hyphema. Case material from the literature and from the files of the Massachusetts Eye and Ear Infirmary is presented to demonstrate that spontaneous hyphema may occur in retinoblastoma, retinoschisis, retrolental fibroplasia, persistent primary hyperplastic vitreous, blood dyscrasias, and certain other less frequent conditions. Spontaneous hyphema may also occur several months after an initial episode of trauma. Case Material and Review Retinoblastoma. —Retinoblastoma is occasionally associated with nontraumatic bleeding into the anterior chamber, as the following patients demonstrate. In the first patient, hyphema heralded retinoblastoma in a remaining eye. The bleeding iris tumors were apparently metastatic from the opposite orbit. In the second patient, discoloration of the iris was associated with retinoblastoma, and hyphema was an early sign of iris seeding in an