Study Identifies Risk Factors for Subconjunctival Hemorrhage Among Contact Lens Wearers
Date: August 26, 2010 // Author: Gary Heiting, ODThe presence of pinguecula and loosening or excess growth of the conjunctiva are risk factors for the development of subconjunctival hemorrhage (SCH) among contact lens wearers, according to a study published online this month by the American Journal of Ophthalmology.
Researchers in Japan evaluated 45 contact lens wearers (ages 18 to 45) with SCH, 200 age-matched control subjects who did not wear contact lenses and 200 age-matched controls who wore contacts. None of the eyes in the control groups had subconjunctival hemorrhages.
The conjunctiva (the clear, thin membrane overlying the sclera or “white” of the eye) was divided into eight equal regions and evaluated for the presence of pinguecula, conjunctivochalasis (loosening and/or excess growth of the conjunctiva) and other abnormalities.
Results of the study included:
- Contact lens-related SCH typically affected one or two temporal (lateral, closer to the ear) regions of the conjunctiva.
- SCH occurred significantly more frequently in eyes with pinguecula and conjunctivochalasis.
- The effect of downward gaze or digital (finger) pressure on the extent of conjunctivochalasis was more marked in eyes with SCH.
The study authors concluded that pinguecula and conjunctivochalasis are major risk factors for contact lens-related subconjunctival hemorrhage.
Though the exact cause of pinguecula and conjunctivochalasis is unknown, they may result from chronic dry eye, overexposure to the sun’s ultraviolet (UV) radiation or allergy-related swelling with eventual stretching of the conjunctiva.
Severe cases of pinguecula and conjunctivochalasis that are unsightly or cause eye discomfort can be treated surgically.

A consensus opinion doesn’t seem to exist among optometrists, as evidenced by a point-counterpoint discussion of the topic published in the June 2010 issue of Contact Lens Spectrum.
Researchers at