Reasons for visits to an emergency center and hemostatic alterations in patients with recurrent spontaneous subconjunctival hemorrhage.
OBJECTIVE
To evaluate causes of visits to the Eye Emergency Department, determine the prevalence of subconjunctival hemorrhage (SCH), and assess the role of hemostatic abnormalities among patients with spontaneous recurrent SCH (SRSCH).


METHODS
In a prospective study conducted over 2 years, hemostatic function was studied in a subgroup of 105 consecutive patients (39 male) with SRSCH free of systemic risk factors and in 53 age- and sex-matched healthy controls (HC) (24 male).


RESULTS
A total of 10,090 patients (mean age 57.2 ± 16.7 years, range 0-94, median 58.4) were evaluated. A total of 39.3% had ocular trauma, 34.9% inflammatory ocular surface disorder, 5.7% floaters, 3.3% visual symptoms of neurologic origin, 1.6% uveitis, 1.5% ocular hypertension, 0.8% retinal tear or detachment, 0.7% retinal vascular disease, and 0.5% other causes. A total of 1.6% of the patients were hospitalized. A total of 11.7% of patients had SCH: in 86.7% it was spontaneous, in 13.3% consequent to trauma or to ocular surface disorders. A total of 105 patients had SRSCH, and the prevalence of hemostatic abnormalities among them was not different from HC. Type I von Willebrand disease was diagnosed in 1 patient with SCH and in none of the HC (χ² = 0.13, p = 0.72).


CONCLUSIONS
Most patients had ocular infection or trauma and were treated on an outpatient basis; SCH was the third cause of access. The large majority of SCH were unprovoked, and the prevalence of hemostatic alterations in patients with SRSCH and no systemic causes was not different from the general population. Hemostatic screening or second level blood clotting tests were of no use in these patients.
Department of Surgical and Biomedical Sciences, Division of Ophthalmology, University of Perugia, Perugia - Italy.
Carlo
C
Cagini
Department of Surgical and Biomedical Sciences, Division of Ophthalmology, University of Perugia, Perugia - Italy.
Alessia
A
Iannone
Department of Surgical and Biomedical Sciences, Division of Ophthalmology, University of Perugia, Perugia - Italy.
Anna
A
Bartolini
Department of Surgical and Biomedical Sciences, Division of Ophthalmology, University of Perugia, Perugia - Italy.
Tito
T
Fiore
Department of Medicine, Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia - Italy.
Tiziana
T
Fierro
Department of Medicine, Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia - Italy.
Paolo
P
Gresele
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003229:Conjunctival Diseases / Q000097:blood / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005130:Eye Hemorrhage / Q000097:blood / Q000453:epidemiology*; D005131:Eye Injuries / Q000453:epidemiology; D005260:Female; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D017678:Sex Distribution