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      Recent Causes of Subconjunctival Hemorrhage

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          Abstract

          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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          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.
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                Author and article information

                Journal
                OPH
                Ophthalmologica
                10.1159/issn.0030-3755
                Ophthalmologica
                S. Karger AG
                0030-3755
                1423-0267
                2010
                April 2010
                09 September 2009
                : 224
                : 3
                : 133-137
                Affiliations
                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
                Article
                236038 Ophthalmologica 2010;224:133–137
                10.1159/000236038
                19738393
                19bdf15f-7199-4866-8d60-a8f5bae31409
                © 2009 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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

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

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