Causes and Risk Factors for Conjunctival Hemorrhages

Common Causes

• Contact lens usage, particularly with poor lens hygiene or prolonged wearing time, is a common cause of subconjunctival hemorrhage 1
• Viral conjunctivitis, particularly Epstein-Barr virus, can present with hemorrhagic conjunctivitis 2
• Adenoviral conjunctivitis can cause severe conjunctival injection 3

Less Common Causes

• Vasculitis associated with conditions such as sarcoidosis, granulomatosis with polyangiitis, Kawasaki disease, and microscopic polyangiitis can cause conjunctival hemorrhages 4, 5, 6
• Sebaceous carcinoma can present with intense bulbar conjunctival injection 4
• Conjunctival lymphoma can present with chronic palpebral or bulbar follicles 5
• Ocular surface squamous neoplasia is associated with conjunctival hyperemia 5

Clinical Pearls

• Misdiagnosing sebaceous carcinoma as chronic blepharoconjunctivitis is a common pitfall 1