What is the cause of subconjunctival hemorrhage (bleeding in the conjunctiva)?

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Differential Diagnosis for Bleeding in Conjunctiva

  • Single most likely diagnosis
    • Subconjunctival hemorrhage: This is the most common cause of bleeding in the conjunctiva, often resulting from a sudden increase in pressure (e.g., coughing, sneezing, or straining) that causes small blood vessels in the conjunctiva to rupture. It is usually benign and resolves on its own.
  • Other Likely diagnoses
    • Conjunctivitis: Inflammation of the conjunctiva can lead to bleeding, especially if caused by an infectious agent or an allergic reaction.
    • Trauma: Direct injury to the eye can cause bleeding in the conjunctiva.
    • Contact lens-related complications: Poorly fitting lenses or lens-related eye infections can lead to conjunctival bleeding.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Hypertension: Uncontrolled high blood pressure can lead to conjunctival bleeding due to vascular damage.
    • Diabetes mellitus: Diabetic retinopathy can cause bleeding in the eye, including the conjunctiva.
    • Sickle cell disease: This condition can lead to vascular occlusions and subsequent bleeding in various parts of the body, including the eyes.
    • Infectious diseases (e.g., endophthalmitis): Severe infections within the eye can cause conjunctival bleeding and are medical emergencies.
  • Rare diagnoses
    • Amyloidosis: A condition characterized by the deposition of abnormal proteins (amyloid) in various tissues, including the conjunctiva, which can lead to bleeding.
    • Vasculitis: Inflammation of blood vessels can cause conjunctival bleeding, although this is a rare condition.
    • Tumors: Benign or malignant tumors of the conjunctiva can cause bleeding, but these are uncommon.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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