Subconjunctival hemorrhage causes
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Common Causes of Subconjunctival Hemorrhage
Subconjunctival hemorrhage (SCH) is most often caused by minor local trauma, such as rubbing the eyes, accidental bumps, or injuries. In younger people and children, trauma is the leading cause, accounting for the vast majority of cases in these age groups Fukuyama1990Mimura2009Parikh2020+2 MORE. Other common causes include contact lens-related injuries and acute conjunctivitis, especially in younger patients Fukuyama1990Mimura2009Tarlan2013.
Systemic Risk Factors: Hypertension and Vascular Disease
In older adults, systemic conditions become more important. High blood pressure (hypertension) is the most frequent risk factor for SCH in the elderly, followed by diabetes and arteriosclerosis. These conditions can weaken blood vessels, making them more likely to rupture spontaneously Fukuyama1990Mimura2009Tarlan2013+1 MORE. Because of this, it is recommended to check blood pressure in older patients who present with SCH Fukuyama1990Mimura2009Tarlan2013.
Less Common and Rare Causes
Other less common causes of subconjunctival hemorrhage include:
- Sudden increases in pressure from coughing, sneezing, vomiting, or heavy lifting (Valsalva maneuver) Göktepe2020Luthra2020.
- Bleeding disorders or use of medications that affect blood clotting Göktepe2020Tarlan2013.
- Ocular or systemic infections, such as conjunctivitis Fukuyama1990Parikh2020Göktepe2020.
- Eye surgery or procedures, including cosmetic fillers near the eyes Parikh2020Göktepe2020Luthra2020.
- Rarely, SCH can be linked to underlying tumors, vascular malformations, or systemic diseases like leukemia Göktepe2020Tarlan2013.
- In very rare cases, SCH can be associated with cyclical hormonal changes, such as ocular vicarious menstruation, where bleeding occurs in sync with the menstrual cycle .
Subconjunctival Hemorrhage in Children
In children, SCH is uncommon but, when it does occur, trauma is the main cause. Ocular surface inflammation (like conjunctivitis), vessel rupture from coughing or choking, and very rarely, blood clotting disorders, can also be responsible . Because trauma is so common, it is important to carefully examine children with SCH for other signs of injury .
Conclusion
Subconjunctival hemorrhage is usually a benign and self-limiting condition. The most common causes are trauma and local injury in younger people and children, while systemic hypertension is the leading cause in older adults. Other factors, such as infections, sudden pressure changes, bleeding disorders, and rare systemic or hormonal conditions, can also contribute. A careful history and examination are important to identify the underlying cause, especially in recurrent or unexplained cases.
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Causes of subconjunctival hemorrhage.
Subconjunctival hemorrhage is caused by minor local trauma, systemic hypertension, and acute conjunctivitis, with blood pressures being crucial in patients with these conditions.
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