Bilateral hyphaema in dogs: causes and first tests
7-year-old German Shepherd with blood in the anterior chamber of both eyes, appearing over the last 24 hours. There is no history of trauma. There are petechiae on the oral mucosa.
Which tests are a priority?
chevron_right Show answer and explanation
A. Ocular ultrasound and skull radiographs to look for fractures
Ocular ultrasound is useful for assessing the posterior segment, but with no trauma and petechiae the priority is to look for a systemic haemostatic disorder.
B. Conjunctival cytology and bacterial culture
They give no information on the origin of intraocular bleeding.
C. Platelet count, clotting times, blood pressure and Ehrlichia serology
Correct. Bilateral hyphaema without trauma suggests systemic disease. Petechiae point to thrombocytopenia, and in Spain ehrlichiosis (German Shepherds develop severe forms) is a major cause, alongside immune-mediated thrombocytopenia, anticoagulant rodenticides and hypertension.
D. Gonioscopy to assess the iridocorneal angle
Blood prevents assessment of the angle, and gonioscopy does not indicate the cause of the bleeding.
lightbulb Key takeaway
Unilateral hyphaema: think first of trauma, intraocular neoplasia or retinal detachment. Bilateral hyphaema: coagulopathy, thrombocytopenia, hypertension or vasculitis. Measure intraocular pressure: hyphaema can cause secondary glaucoma.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.