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Prevalence and Causes of Subconjunctival Hemorrhage in Children

Alomi O Parikh, Cindy W Christian, Brian J Forbes

    Pediatric Emergency Care
    |June 13, 2022
    PubMed

    Insights

    Subconjunctival hemorrhage (SCH) is rare in children, with trauma being the most frequent cause. All children with SCH require thorough examination for associated injuries.

    Area of Science:

    • Pediatric Ophthalmology
    • Ocular Trauma
    • Child Abuse Detection

    Background:

    • Subconjunctival hemorrhage (SCH) is a potential indicator of abusive head trauma in children.
    • Limited data exists on the prevalence and causes of SCH in pediatric populations.

    Purpose of the Study:

    • To determine the prevalence of subconjunctival hemorrhage in children.
    • To identify the primary causes of subconjunctival hemorrhage in pediatric patients.

    Main Methods:

    • Retrospective cross-sectional study of pediatric ophthalmology outpatient visits over four years.
    • Analysis of patient history, ocular and non-ocular findings, and diagnostic studies.
    • Prevalence calculation with and without exclusion of post-surgical cases.

    Main Results:

    • A total of 33,990 children were studied, with 949 cases of SCH (1.1%).
    • Excluding surgery, 313 cases (0.4%) were identified, predominantly due to trauma (83%) and ocular inflammation (13%).
    • Trauma and inflammation accounted for 94-97% of all pediatric SCH cases across all age groups.

    Conclusions:

    • Subconjunctival hemorrhage is an infrequent finding in children.
    • Trauma is the leading cause of SCH in pediatric patients.
    • Comprehensive evaluation is crucial for all children with SCH to detect potential trauma.
    Abstract

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