Differential Diagnosis for Bleeding Conjunctiva
- Single most likely diagnosis
- Subconjunctival hemorrhage: This condition is characterized by bleeding underneath the conjunctiva, the clear membrane covering the white part of the eye. It is often caused by a sudden increase in pressure, such as from coughing, sneezing, or straining, and can also be due to trauma, high blood pressure, or bleeding disorders. It's the most likely diagnosis because it directly matches the symptom of bleeding conjunctiva and is relatively common.
- Other Likely diagnoses
- Conjunctivitis: Inflammation of the conjunctiva can lead to bleeding, especially if it's caused by an infection or an allergic reaction. The presence of redness, itching, and discharge would support this diagnosis.
- Trauma: Direct injury to the eye can cause bleeding in the conjunctiva. The history of a recent injury would make this a likely consideration.
- Dry eye syndrome: Severe dryness can lead to minor bleeding due to the breakdown of the conjunctival surface.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Scleritis: Inflammation of the sclera, the white part of the eye, can cause severe pain and can lead to conjunctival bleeding. Missing this diagnosis could lead to vision loss.
- Orbital cellulitis: An infection of the tissues surrounding the eye can cause conjunctival bleeding among other symptoms like swelling and vision changes. It's a medical emergency due to the risk of spreading infection.
- Malignant tumors: Although rare, tumors like conjunctival lymphoma or squamous cell carcinoma can present with bleeding.
- Rare diagnoses
- Amyloidosis: A condition where abnormal proteins (amyloid) accumulate in various parts of the body, including the conjunctiva, potentially causing bleeding.
- Ehlers-Danlos syndrome: A genetic disorder affecting connective tissue, which can lead to easy bruising and bleeding, including in the conjunctiva.
- Scurvy: Vitamin C deficiency can lead to fragile blood vessels, including those in the conjunctiva, resulting in bleeding.