Intas Polivet (2012) Vol.

13 (I): 48-49 Short Communication

Needle Aspiration technique for the management of
Hyphema in a Bullock
R.B. Kushwaiia', J.S. Soodan' and Sharad Kumar^
Division of Teaching Veterinary Ciinicai Compiex
Faculty of Veterinary Sciences and Animai Husbandry
Sher-e-Kashmir University of Agricuitural Sciences and Technology
R.S. Pura
Jammu - 181102 (Jammu and Kashmir)
Abstract
A buiiock was presented with the history of trauma to the right eye and accumuiation of blood in the lower 1/3'='
portion of anterior chamber of the right eye. The case was diagnosed as Hyphema. The collected biood was aspirated
successfuliy using 16 G hypodermic needie from 2ciock position in left iaterai recumbency under xyiazine sedation
and Peterson's nerve and Auriculopalpebral nerve block. After complete aspiration of blood, eyeball was washed
with normal saline solution foilowed by subconjunctival injection of gentamicin and dexamethasone in buibar region.
Post-operativeiy, animai was treated with antibiotic and anti-infiammatory ophthaimic applications. Bullock's eye
became normal within three weeks.
Keywords: Buiiock; Hyphema; Needie aspiration technique
Introduction
Hyphema is an accumulation of blood in fhe
anterior chamber of eye (Sarma, 2009). The
condifion is mosfly seen following trauma fo eye
and reported in almosf all domestic and pef animals
(Ismail, 1990). This communication describes the
needle aspirafion fechnique for fhe management
of hyphema in a bullock.
History and Examination
An adulf bullock was reported wifh fhe hisfory of
unknown trauma fo fhe right eye for last fifteen
days. An ocular anfibiofic drop has been insfilled
info fhe aftected eye without any improvement.
Accumulation of blood in dependenf part of the
anterior chamber up to 1/3'" portion was observed
(Fig.1 ). Ocular discharge and frequent blinking was
nof observed. Affer a formal discussion with
animal's owner, if was planned fo aspirafe fhe
blood under local anaesthesia.
Treatment and Discussion
The bullock was adminisfered wifh 1 ml xylazine
(20 mg) intramuscularly for sedafion and resfrained
in left lateral recumbency. The area jusf caudal fo
lateral canthus was shaved and swabbed wifh spirit
1. Assistant Professor and Corresponding Author
e-maii: kushwaharb@rediffmaii.com
2. Professor and Head
3. Assistant Professor
for Peterson's and Auriculopalpebral nerve block.
Peterson's eye block was achieved by
administration of 15 ml 2% lignocaine solufion
using 18 G spinal needle af fhe junction of
supraorbital process and zygomafic arch.
Auriculopalpebral nerve was blocked by infilfrafion
of 5 ml of lignocaine solufion beneath the skin
caudal fo fhe sife of Peterson nerve block in a fan
shaped.
After proper Auriculopalpebral and Peterson nerve
block, fhe buibar surtace was washed wifh normai
saline solufion. A sfay sufure was applied in upper
buibar conjuncfiva fo bring fhe globe in cenfre using
braided silk which was pulled and held by an
assistant throughout the procedure. A sferile 16 G
hypodermic needle was penefrafed from 2clock
posifion towards centre of anferior chamber. As
soon as needle enfered info anterior chamber,
most of fhe blood was drained ouf passively; fhe
remaining blood was aspirated by an attaching
syringe (Fig. 2). The needle was taken out carefully
and eye ball was again washed with normal
saline solufion. No blood was seen in fhe anterior
chamber (Fig. 3). However, slighf shrinkage in
cornea was noticed due fo reducfion in aqueous
humor amount. The anferior chamber was nof
irrigated with any solufion. However, Chawla ef
al. (2001) mentioned fhaf irrigation wifh fibrinolysin
solufion helps in complete aspirafion. Magrene
48
Kushwaha et al.
(1977) and Slatter (1993) have also advocated
surgical drainage of clot if not absorbed within 48
hours. However, Sarma (2009) treated a case of
hyphema in an elephant calf by instillation of
medicine only and concluded that small clot not
requires any surgical intervention.
Fig. 1 : Accumulation of blood in anterior chamber
Fig. 3: After aspiration of blood
After washing of eyeball with normal saline
sol uti on, 0.5ml Gentamicin and 0.5ml
Dexamethasone was mixed in 2ml syringe and
injected beneath the conjunctiva in bulbar region.
Other treatment consisted of injection Ouinlntas'
(Enrofloxacin) 15ml i.m., Melonex^ (Meloxicam)
15 ml i.m. daily for three days and eye drops
Sofracort'' five drops daily for seven days, Atro
drops" 3-4 drops daily for five days and Neosporin-
H'' ointment applied twice a day over eyelids
margin for seven days. Atropine sulphate eye
drops (Atro drops") preclude adhesion of cornea
with iris by dilation of pupil. Animal's owner told
Fig. 2: Penetration of needle in cornea at 2clock
position close to limbus for aspiration of blood. Note
the stay suture at upper bulbar conjunctiva
on telephone that mild corneal opacity seen at
the site of puncture which disappeared gradually
in third week after operation. The present paper
reported a case of hyphema in a bullock and its
successful management by aspiration technique
using 16 G hypodermic needle.
References
Chawla, S. K., Panchbhal, V. S. and Gahlot, T. K. (2001).
The special sense organs: Eye. In: Ruminant Surgery,
Eds by R.P. S. Tyagi and Jit Singh, CBS Publisher, New
Delhi. P. 407.
Ismail, S.F. (1990). Hyphema (Hyphaemia) in domestic
animals. Assiut Vet. Med. J. 24: 233-39.
Magrene, W.G. (1977). Hyphema drainage. Canine
Ophthalmology. 3'" Edn. Lea and Febiger, Philadelphia,
p.15O.
Sarma, B. (2009). Hyphema of an Elephant Calf. Intas
Polivet ^0:42^-22.
Siatter, D.H. (1993). Occular emergency and trauma.
In: Text of Small Animai Surgery. Vol. 2, W. B. Saunders
Co., Philadelphia, p. 1287.
a - Brand of Intas Animal Health, Ahmedabad
b - Brand of Sanofi Aventis Pharma, Mumbai
c - Brand of Intas Pharma Ltd., Ahmedabad
d - Brand of Giaxo Smithkline Pharma Ltd., Mumbai
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