Recurrent Subconjunctival Hemorrhages Research Articles

Башкирский государственный медицинский университет, Уфа, Россия

Chronic myeloproliferative disorders (CMPD) include hemoblastoses with abnormal proliferation of myeloid lineages and concomitant alterations in the peripheral blood indicators. The aim of this study was to assess the frequency and structure of ophthalmic complications as a quality of life factor in patients with CMPD. A group of patients with hemoblastoses of this type (n = 41) were surveyed using National Eye Institute Visual Function Questionnaire-25 along with a comprehensive examination by noninvasive ophthalmological techniques. The patients typically reported impaired visual acuity, visual discomfort and foreign body sensation in the eyes. Though many of the patients assessed their general health and vision as satisfactory, the vast majority (68.3%) expressed serious concerns about their visual abilities. The ophthalmological examination revealed various defects including refractive errors (61%), corkscrew dilation and tortuosity of conjunctival and retinal vessels (77.9%), recurrent subconjunctival hemorrhages (39%) and dilated optic nerve sheaths (36.6%). The survey data indicate that visual impairments significantly affect quality of life in patients with CMPD. Overall, the results underscore the importance of interdisciplinary approach in the management of patients with CMPD to enable early diagnosis and feasible correction of the ophthalmic component.

Correlation Between Recurrent Subconjunctival Hemorrhages and Conjunctivochalasis by Clinical Profile and Successful Surgical Outcome.

To characterize the clinical profile of patients with recurrent subconjunctival hemorrhages (SCHs) and evaluate the effect of conjunctivochalasis (CCh) surgery on disease recurrences. Three hundred and sixty-two patients with SCHs (mean age, 56.4±16.0 years) were enrolled in this multicenter epidemiologic study. The severity of CCh, lifestyle at the time of SCH onset, and the frequency of previous SCHs were compared. Thirty-eight patients with 2 or more episodes of SCHs (mean age, 68.2±8.9 years) underwent surgery for CCh. The effectiveness of surgery was evaluated by comparing the frequency of SCH preoperatively and postoperatively. Patients with three or more recurrent SCHs showed a significantly (P=0.003) higher grade of CCh and tended to be engaged in activities that require visual concentration, such as watching a visual display terminal, knitting, reading, and driving. More than 80% of eyes that underwent surgery to CCh showed no recurrence of the hemorrhages, and the frequency of SCH significantly (P<0.0001) decreased postoperatively. Moderate or severe CCh and activities that may cause dry eye can be considered to be risk factors for recurrent SCHs. Surgery to treat CCh is a useful option for patients with frequent recurrences of SCHs.

Recurrent subconjunctival hemorrhage due to cavernous hemangioma of the conjunctiva

ObjectiveTo report 3 patients with conjunctival cavernous hemangioma in association with multiple recurrent episodes of subconjunctival hemorrhage. DesignRetrospective clinical case series. ParticipantsWe studied 3 patients, 11, 13, and 21 years of age, respectively, each of whom had a small, solitary, and irregular multiloculated vascular mass on the temporal bulbar conjunctiva of the right eye. The tumours were excised for cosmetic reasons. MethodsThe medical records and histopathologic slides of the 3 patients were reviewed. ResultsHistopathologic examination showed that the tumours were composed of large, congested blood vessels separated by thin connective tissue. The patients did not have any recurrence of the tumour or hemorrhage. ConclusionsCavernous hemangioma had a tendency to develop rapidly in young people on the temporal bulbar conjunctiva of the right eye, causing recurrent subconjunctival hemorrhages.

Recurrent subconjunctival hemorrhages leading to the discovery of ocular adnexal lymphoma

Background Subconjunctival hemorrhages commonly occur idiopathically or from causes including ocular surgery, trauma, anticoagulation medications, or a Valsalva maneuver. When a hemorrhage persists or recurs, a more extensive list of differential diagnoses must be considered. This report details a case in which persistent subconjunctival hemorrhages led to the discovery of ocular adnexal lymphoma. Case Report A 68-year-old white man presented with a 7- to 8-month history of a recurrent red left eye. There was no associated pain, discharge, or change in vision over that time. The right eye was never involved. An ocular examination of the left eye found a mild nasal subconjunctival hemorrhage and a salmon-pink–colored lesion involving the superior conjunctiva. Clinical findings, photos, magnetic resonance images, and histopathology results are presented and reviewed. The signs, symptoms, incidence, pathophysiology, treatment, and prognosis of ocular adnexal lymphoma are also discussed. Conclusion Lymphomas can occur in a variety of sites in the body. It is well documented that primary tumors can originate in the ocular adnexa. Although not typical, the first sign in this case was a recurrent subconjunctival hemorrhage. The importance of a thorough ocular examination is paramount for a patient's ocular health and possibly the patient's life.

Anaplastic Carcinoma of the Lacrimal Gland Presenting with Recurrent Subconjunctival Hemorrhages and Displaying Incipient Sebaceous Differentiation

Primary adenocarcinomas of the lacrimal gland rarely display sebaceous differentiation. An anaplastic lacrimal gland neoplasm manifesting this feature was excised from a 64-year-old man who initially appeared with recurrent painless subconjunctival hemorrhages. Globe displacement and tumor-induced hyperopia were later findings. Electron microscopic studies performed on the widely excised tumor documented prominent lipid vacuoles, desmosomes, scattered cytoplasmic filaments, and linear segments of basement membrane material. The patient refused radical surgery and instead opted for 6,000 rads of adjuvant radiotherapy. Eleven months postoperatively liver and bone metastases developed, but he was free of local orbital recurrence. Twenty-two months postoperatively he died from complications of his metastatic disease. This most unusual lacrimal neoplasm is discussed in terms of its initial signs and symptoms and its histopathology. When the current case is analyzed in combination with three earlier reports, there is evidence that primary lacrimal gland sebaceous carcinoma is probably among the most malignant orbital tumors due to its uniform early fatality.

The Removal of Scleral Buckles

Six hundred consecutive retinal detachments were operated on with silicone scleral buckles. Twenty-three implants, or 3.8%, were removed. There was one solid silicone implant and 22 silicone sponges. Removal was required because of infection (seven eyes), foreign-body sensation without infection (seven eyes), recurrent subconjunctival hemorrhages (four eyes), impingement on the optic nerve (one eye), and distortion of the macula (four eyes). The postoperative infection rate was 1.8% for silicone sponges, and there were no infections in eyes buckled with solid silicone. Only one retina redetached after buckle removal, yielding a recurrence rate of 4%. The one recurrence was successfully managed by a second scleral buckle.

FOREIGN BODY IN THE EYE

<h3>To the Editor.</h3> —Regarding the query on feeling of foreign body in the eye (Arch Ophthal<b>76</b>:902 [Dec] 1966), one more very frequently overlooked possibility in patients of this age and older is senile laxity of the conjunctiva when it is thrown into folds by movement of the eye and pressure by the lids especially at the lower limbus (Hughes, W.L.: Conjunctivochalasis,<i>Amer J Ophthal</i><b>25</b>:48, 1942). Other manifestations of this condition are sudden sharp pains, recurrent subconjunctival hemorrhages, and even peripheral marginal corneal ulceration in severe cases. P. S. I enjoy the new query department very much.