After a traumatic hyphema, how long should gonioscopy be deferred?

After a traumatic hyphema, how long should gonioscopy be deferred?

• A. 1 week
• B. 1 month
• C. 1 day
• D. 1 year

Answer: (B)

After a traumatic hyphema, you want to let the anterior chamber clear and the eye settle before examining the angle. Gonioscopy too early is unreliable because blood, clots, and corneal edema obscure the angle landmarks and can mimic or hide angle abnormalities. Waiting about a month allows most of the blood to resolve, inflammation to subside, and the healing process to complete so you can accurately assess for injuries like angle recession and avoid provoking a rebleed during the examination. If concerns remain about the angle after the eye has settled, a follow-up gonioscopy can be considered.

After a traumatic hyphema, you want to let the anterior chamber clear and the eye settle before examining the angle. Gonioscopy too early is unreliable because blood, clots, and corneal edema obscure the angle landmarks and can mimic or hide angle abnormalities. Waiting about a month allows most of the blood to resolve, inflammation to subside, and the healing process to complete so you can accurately assess for injuries like angle recession and avoid provoking a rebleed during the examination. If concerns remain about the angle after the eye has settled, a follow-up gonioscopy can be considered.