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      Recent Causes of Subconjunctival Hemorrhage


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          Purpose: To assess the relationship between the incidence of subconjunctival hemorrhage (SCH) and age during each season of the year, and to examine recent risk factors for SCH. Methods: A total of 161 patients with SCH aged 1–94 years were involved in the study. The age, gender, medical history and ocular history were determined for all subjects. Results: The peak age of onset of SCH was between 61 and 70 years. Fourteen patients (77.7%) had trauma or contact-lens-induced injury, and 4 patients (22.3%) among the younger patients aged 0–40 years had an unknown etiology. Among the older patients aged 61–94 years, the chief risk factor for SCH was hypertension (47.5%), followed by unknown etiology (39.4%) and then diabetes (13.1%). Conclusion: These results suggest that the major current risk factors for SCH are trauma and contact-lens-induced injury in younger patients, while hypertension is the main factor in older patients. The incidence of acute hemorrhagic conjunctivitis was decreased.

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          Most cited references6

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          Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III.

          The purpose of the present study was to examine patterns of systolic and diastolic hypertension by age in the nationally representative National Health and Nutrition Examination Survey (NHANES) III and to determine when treatment and control efforts should be recommended. Percentage distribution of 3 blood pressure subtypes (isolated systolic hypertension, combined systolic/diastolic hypertension, and isolated diastolic hypertension) was categorized for uncontrolled hypertension (untreated and inadequately treated) in 2 age groups (ages /=50 years). Overall, isolated systolic hypertension was the most frequent subtype of uncontrolled hypertension (65%). Most subjects with hypertension (74%) were >/=50 years of age, and of this untreated older group, nearly all (94%) were accurately staged by systolic blood pressure alone, in contrast to subjects in the untreated younger group, who were best staged by diastolic blood pressure. Furthermore, most subjects (80%) in the older untreated and the inadequately treated groups had isolated systolic hypertension and required a greater reduction in systolic blood pressure than in the younger groups (-13.3 and -16.5 mm Hg versus -6.8 and -6.1 mm Hg, respectively; P:=0.0001) to attain a systolic blood pressure treatment goal of <140 mm Hg. Contrary to previous perceptions, isolated systolic hypertension was the majority subtype of uncontrolled hypertension in subjects of ages 50 to 59 years, comprised 87% frequency for subjects in the sixth decade of life, and required greater reduction in systolic blood pressure in these subjects to reach treatment goal compared with subjects in the younger group. Better awareness of this middle-aged and older high-risk group and more aggressive antihypertensive therapy are necessary to address this treatment gap.
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            Systolic versus diastolic blood pressure and risk of coronary heart disease

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              Causes of Subconjunctival Hemorrhage

              We examined prospectively 8,726 patients in outpatient eye clinics. A total of 225 (2.9%) patients had subconjunctival hemorrhage. No sexual or age predilection was found. The most common causes for the condition were minor local trauma, systemic hypertension, and acute conjunctivitis. Subconjunctival hemorrhages resulting from local trauma were frequent in the summer, and those associated with systemic hypertension were noted most often in older patients. Blood pressures should be examined in patients with subconjunctival hemorrhages, particularly in older patients.

                Author and article information

                S. Karger AG
                April 2010
                09 September 2009
                : 224
                : 3
                : 133-137
                aDepartment of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, and bDepartment of Ophthalmology, Yachiyo Medical Center, Tokyo Women’s Medical University, Chiba, Japan
                236038 Ophthalmologica 2010;224:133–137
                © 2009 S. Karger AG, Basel

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                : 20 March 2008
                : 28 July 2008
                Page count
                Figures: 4, Tables: 1, References: 13, Pages: 5
                Original Paper

                Vision sciences,Ophthalmology & Optometry,Pathology
                Hypertension,Contact lens,Subconjunctival hemorrhage, seasonal variation


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