Contact lens-induced subconjunctival hemorrhage.
OBJECTIVE
To present the first detailed assessment of the clinical features of CL-induced subconjunctival hemorrhage and associated risk factors.


METHODS
Cross-sectional and case-control study of age-matched randomized groups.


METHODS
A total of 45 CL wearers with subconjunctival hemorrhage aged 18 to 45 years (CL-Hemorrhage group), 200 age-matched healthy control subjects (non-CL group), and 200 age-matched CL wearers (CL group) were enrolled. The conjunctiva was divided into the following 8 equal areas: superior, superior/nasal, nasal, inferior/nasal, inferior, inferior/temporal, temporal, and superior/temporal. The site of hemorrhage, the grade, and other parameters of conjunctivochalasis at 3 locations (nasal, middle, and temporal), and the grade of pinguecula on the nasal or temporal conjunctiva were determined in all subjects.


RESULTS
Typically, subconjunctival hemorrhage affected 1 or 2 regions of the temporal conjunctiva. The grade of conjunctivochalasis and pinguecula was higher in both the affected and unaffected eyes of the CL-Hemorrhage group than the non-CL and CL groups (all P < .00001). The effect of downward gaze or digital pressure on the extent of conjunctivochalasis was more marked in the CL-Hemorrhage group and superficial punctate keratitis was more common (all P < .00001). Multivariate logistic regression analysis of variables revealed that the presence of conjunctivochalasis and pinguecula were associated with an increased risk of CL-induced subconjunctival hemorrhage (all P < .05).


CONCLUSIONS
These results suggest that the major risk factors for CL-induced subconjunctival hemorrhage are conjunctivochalasis and pinguecula.
Mimura
Tatsuya
T
Department of Ophthalmology, Toranomon Hospital, Tokyo, Japan. mimurat-tky@umin.ac.jp
Yamagami
Satoru
S
Mori
Mikiro
M
Funatsu
Hideharu
H
Usui
Tomohiko
T
Noma
Hidetaka
H
Amano
Shiro
S
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000209:etiology*; D003261:Contact Lenses / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005130:Eye Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012029:Refraction, Ocular; D012307:Risk Factors; D012621:Seasons; D055815:Young Adult