H31.312 Expulsive choroidal hemorrhage, left eye

Name of the Condition

• Expulsive Choroidal Hemorrhage, Left Eye (ICD Code: H31.312)

Summary

Expulsive choroidal hemorrhage of the left 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 left 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 left 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 left eye
• Eye pain or pressure
• Protrusion of intraocular contents (e.g., iris, lens)
• Hemorrhage visible in the anterior or posterior segment of the left eye
• Nausea or vomiting (due to pain)

Diagnosis

Diagnosis involves a thorough clinical examination of the left 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 intraocular pressure, controlling bleeding, and addressing any surgical or traumatic causes. Interventions may include medications to reduce pressure, surgical repair of damaged structures, or supportive care to preserve remaining visual function.

Prognosis and Follow-Up

Prognosis depends on the severity of the hemorrhage and promptness of treatment. Early intervention may help preserve vision, but significant vision loss can occur. Follow-up care involves regular monitoring of visual acuity and intraocular pressure, with adjustments to treatment as needed.

Complications

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

Lifestyle & Prevention

• Avoid activities that risk eye injury (e.g., contact sports without protection)
• Manage vascular health (e.g., control hypertension)
• Follow pre-surgical instructions carefully if undergoing intraocular procedures
• Use protective eyewear in hazardous environments

When to Seek Professional Help

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

Tips for Medical Coders

Document the laterality (left eye) and confirm the condition is expulsive choroidal hemorrhage. Ensure clinical notes support the diagnosis and specify the affected eye to justify the H31.312 code.