Differential Diagnosis for Red Spot on Sclera in Children
- Single Most Likely Diagnosis
- Subconjunctival hemorrhage: This is the most common cause of a red spot on the sclera in children, often resulting from minor trauma, coughing, or straining. It appears as a bright red patch and is usually benign and self-limiting.
- Other Likely Diagnoses
- Conjunctivitis: Inflammation of the conjunctiva can cause redness and may appear as a spot or more diffuse redness. It can be infectious (viral or bacterial) or allergic.
- Scleritis: Inflammation of the sclera itself, which can be painful and is less common in children but can be associated with systemic diseases.
- Episcleritis: An inflammatory condition of the episclera, a thin layer on top of the sclera, which can cause redness and is often benign and self-limiting.
- Do Not Miss Diagnoses
- Retinoblastoma with secondary scleral invasion: Although rare, retinoblastoma is a malignant tumor of the retina that can invade the sclera and present with a red spot. Early detection is crucial for treatment and prognosis.
- Endophthalmitis: A severe infection within the eye that can result from trauma, surgery, or blood-borne infection. It is a medical emergency requiring prompt treatment.
- Scleral rupture: A serious condition resulting from significant trauma to the eye, which can lead to vision loss if not promptly addressed.
- Rare Diagnoses
- Scleral melanoma: A rare tumor of the sclera, more commonly found in adults but can occur in children. It presents as a pigmented lesion rather than a red spot but can have a similar appearance in its early stages.
- Scleromalacia perforans: A rare, painless, and progressive thinning of the sclera, often associated with systemic autoimmune diseases like rheumatoid arthritis. It is extremely rare in children.
- Staphyloma: An abnormal protrusion of the uveal tissue (including the sclera) through a weak point, which can be congenital or acquired. It might appear as a red spot or bulge on the sclera.