H31.311 Expulsive choroidal hemorrhage, right eye

Name of the Condition

• Expulsive Choroidal Hemorrhage, Right Eye (ICD Code: H31.311)

Summary

Expulsive choroidal hemorrhage of the right eye is a severe form of bleeding within the choroid, the vascular layer of the eye, often associated with intraocular surgery or trauma. This condition can lead to sudden vision loss and structural damage to the right eye, requiring prompt medical attention to manage complications and preserve visual function.

Causes

Expulsive choroidal hemorrhage typically occurs during or after intraocular procedures, such as cataract surgery, due to sudden changes in intraocular pressure. It may also result from direct trauma to the right eye, which disrupts the choroidal vasculature and causes rapid hemorrhage.

Risk Factors

• Intraocular surgery (e.g., cataract extraction)
• Severe eye trauma
• Pre-existing vascular disease (e.g., hypertension)
• Advanced age
• Use of anticoagulant medications
• Prolonged surgical time or intraoperative complications

Symptoms

• Sudden, severe vision loss in the right eye
• Eye pain or pressure
• Protrusion of intraocular contents (e.g., iris, lens)
• Hemorrhage visible in the anterior or posterior segment of the right eye
• Nausea or vomiting (due to pain)

Diagnosis

Diagnosis involves a thorough clinical examination of the right eye, including assessment of intraocular pressure and visualization of the hemorrhage. Imaging studies like B-scan ultrasonography may be used to evaluate the extent of the hemorrhage and associated structural damage.

Treatment Options

Treatment focuses on managing the underlying cause and supporting the eye. This may include measures to control intraocular pressure, surgical intervention to repair damage, and monitoring for complications. Supportive care, such as pain management and visual rehabilitation, may also be necessary.

Prognosis and Follow-Up

Prognosis depends on the severity of the hemorrhage and the timeliness of treatment. Early intervention can improve outcomes, but significant vision loss may occur. Follow-up care is essential to monitor healing, manage complications, and assess visual recovery.

Complications

• Permanent vision loss
• Retinal detachment
• Glaucoma
• Infection
• Phthisis bulbi (shrinkage of the eye)

Lifestyle & Prevention

• Avoid activities that risk eye injury.
• Manage systemic conditions like hypertension.
• Follow post-surgical care instructions after eye procedures.
• Use protective eyewear in high-risk environments.

When to Seek Professional Help

Seek immediate medical attention if you experience sudden vision loss, severe eye pain, or visible bleeding in the right eye, especially after surgery or trauma.

Tips for Medical Coders

Document the laterality (right eye) and confirm the expulsive nature of the hemorrhage. Ensure clinical notes support the diagnosis and specify the affected eye to justify the code H31.311.