Differential Diagnosis for Bleeding Inside the Conjunctiva
Single Most Likely Diagnosis
- Subconjunctival Hemorrhage: This condition is characterized by bleeding underneath the conjunctiva, the thin membrane covering the white part of the eye. It is often caused by a rupture of small blood vessels and can be spontaneous or due to trauma, coughing, sneezing, or straining. The appearance of a bright red patch on the white of the eye is a hallmark, and it typically resolves on its own within a couple of weeks.
Other Likely Diagnoses
- Conjunctivitis: Inflammation of the conjunctiva can sometimes lead to bleeding, especially if the cause is an infection or an allergic reaction that leads to significant conjunctival irritation.
- Trauma: Direct injury to the eye can cause bleeding under the conjunctiva, among other potential eye injuries.
- Scleritis: Inflammation of the sclera, the white part of the eye, can sometimes cause bleeding under the conjunctiva, especially if the inflammation is severe.
Do Not Miss Diagnoses
- Hypertension: Uncontrolled high blood pressure can lead to the rupture of small blood vessels in various parts of the body, including under the conjunctiva. Missing this diagnosis could lead to more severe systemic complications if the hypertension remains untreated.
- Blood Disorders (e.g., Hemophilia, Sickle Cell Disease): Certain blood disorders can increase the risk of bleeding, including under the conjunctiva. Failing to diagnose and manage these conditions could lead to recurrent or severe bleeding episodes.
- Infectious Diseases (e.g., Endophthalmitis): Although less common, certain severe infections within the eye can cause bleeding under the conjunctiva. These conditions are medical emergencies and require prompt treatment to preserve vision.
Rare Diagnoses
- Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, which can include the conjunctiva and lead to bleeding.
- Vascular Tumors (e.g., Hemangioma): Rarely, vascular tumors under the conjunctiva can cause bleeding.
- Ehlers-Danlos Syndrome: A genetic disorder that affects the body's connective tissue and can lead to easy bruising and bleeding, including under the conjunctiva, due to fragile blood vessels.