Diffuse and focal hyperaemia of the outer eye in patients with chronic renal failure

In 8 of 57 patients with chronic renal failure that all had deposition of calcium salts in the limboconjunctival area, a focal hyperaemia of the conjunctiva was observed. This focal hyperaemia developed gradually around one or more greyish, slightly elevated, areas situated in the bulbar conjunctiva in the interpalpebral fissure. Clinically these lesions are very much alike inflamed pingueculae. Three patients showed a diffuse inflammatory reaction of the eye that was characterized by a waxy red episcleral and conjunctival hyperaemia extending beyond the palpebral fissure. The average value of the serum calcium concentration in these patients was particularly high and statistically significantly higher than in patients with calcification but without inflammatory signs and also higher than in patients that showed focal hyperaemia. In addition to the focal hyperaemia and the diffuse hyperaemia, we observed another diffuse hyperaemia located principally in the conjunctival tissue. This conjunctival redness often followed the focal hyperaemia associated with pingueculae or preceded the more acute fiery red episcleral hyperaemia, but it could also be present in isolation.