Circumferential lymphangiectasia haemorrhagica conjunctivae: a rare case of spontaneous resolution

Abstract

AbstractPurpose Lymphangiectasia haemorrhagica conjunctivae (LHC) is a rare condition in which the lymphatic channels in the bulbar conjunctiva are dilated and filled with blood. LHC occurs as the result of a connection between conjunctival lymphatic and blood vessels. There have only been a few reported cases of spontaneous attacks followed by rapid resolution. Our purpose is to present the first reported case of LHC involving 360 degrees of bulbar conjunctiva.Methods This case report shows the characteristics of LHC, such as segmental constrictions and balloon‐shaped dilations of blood‐filled lymphatic vessels in the conjunctiva. Anterior segment photographs confirmed that the blood resolved spontaneously in our patient without requiring any further intervention.Results A 36‐year‐old woman complained of spontaneous ocular redness, showing a circumferential engorgement of the bulbar conjunctival vessels consistent with the diagnosis of LHC. One month later, varicose tortuous and transparent lymphatic vessels at the site of previously blood filled vessels were noted as linear bulbar swelling with the classic “string of pearls” appearance. No recurrence was observed after 18 months follow‐up. Surgical excision or laser treatment was not necessary.Conclusion This case is exceptional because of the anatomic location, the full hemorrhagic component of the dilated vessels and the absence of recurrences following its complete resolution. Ophthalmologists should be aware of the possibility of LCH when examining conjunctival hemorrhages.