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Grayish Blue Blotches on Sclera

I work in a preschool and had a four year old boy come in for the first time tonight.  He was punching a baby doll with a great deal of feeling.  I was concerned for him, so I asked him over to find out if he was okay and ask why he was punching the doll.  He said he was fine and that he didn't know why.  As we were talking, I noticed that he had these grayish blue blotches on the whites of his eyes.  Each of the blotches were at the end of the little red lines that we all have on our sclera just under the eye lids.  I had him look up and down...they were on both eyes under the upper and lower lids.  I was concerned that he might have endured a recent injury causing the spots, but now I'm not so sure.  He did say that his older brother hits him and pushes him down.  He referred to him as a "bully".  I would like to talk to the mother about it, but I would like to know if there is something I could tell her about the spots...possible reasons for them...what to be aware of, etc...  Maybe she already knows, but maybe she doesn't...I don't know.  What could cause there to be blotches on the sclera in a four year old child.  To my knowledge he is not from Asian desent.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
The most common cause is thin areas on the sclera allowing the blue choroid underneath to show through.

This is a recent post on blue sclera:

The white part of the eye-the sclera- is normally white and is the outer of the three main layers of the eye "wall". Normally it is whitish in color, under the sclera is the "choroid" the layer that carries the arteries, veins and other blood vessels of the eye. The choroid has pigment cells in it and is dark blue in color, under the choroid and nearest the center of the eye is the "retina". The retina is the sight forming tissue of the eye. The retina is colorless and transparent in health.

When you look at someone's eye you see blood vessels that appear to be on the surface of the sclera. These are in the "conjunctiva" another transparent, elastic tissue that covers the sclera on the surface that we see when we look at someone's eyes. If the conjunctiva is irritated due to allergy, infection, or trauma the blood vessels dilate and the eye looks "blood-shot" or "pink".

The most common color change of the visible sclera is a yellowing that comes with age. This is really a result of the elastic fibers in the conjunctiva yellowing with time and exposure to ultraviolet light from the sun. A yellow thickening often develops at the 3  and 9 o'clock positions called a pingueculum. (a good reason to protect your eyes from extended bright sunlight with a hat and ultra-violet blocking sunglasses).


Now to your specific question. A blue appearance of the sclera is really due to thinning of the sclera allowing the bluish color of the choroid to show through. In older adults there often develops a localized blue spot on the visible conjunctiva called a "scleral plaque". It is not a serious problem and does not require any treatment.  When Ophthalmologists (EyeMDs or MD physicians that do medical and surgical eye care) operate on the back of the eye (especially retinal detachment surgery) there are often areas of blue sclera, sometimes rather large, that represent splits or almost absent areas of sclera. These are called "staphylomas".

Diffuse blue sclera results from thinning of the sclera. This might be present at birth or develop in childhood. Blue sclerae are most importantly associated with types I and II osteogenesis imperfecta. Blue sclera may also be associated with:

Ehler's danlos syndrome
pseudoxanthoma elasticum
Marfan's syndrome

Blue sclera may also be acquired through long-term use of corticosteroids.

There is no specific treatment usually done for blue sclera. Diagnosis and treatment of any underlying disease is very important. If a localized area of thinning is about to rupture sometimes a "scleral patch graft" can be used to strengthen the area.

With your daughter's complex history and the excellent job her physicians have done making these unusual and often difficult diagnoses, I'm sure she's seen a pediatric ophthalmologist and an endocrinologist. They would be in the best position to answer your question more specific to her case. I suggest you discuss your concern with them.
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Hello, I am 19 years old and I've started developing blue veins (ending in a blue-gray small spot) along with red veins in the whites of my eyes under the upper and lower eyelids scantily trying to peep out so as to be visible optimally ,3 years back (I'm not sure about the duration , because this is when I noticed them in an effort to get a hair lash out of my eye). Furthermore,year later ,2 years back I noticed a brown spot on the white of my left eye exactly touching the border of the eyeball. Year back I noticed a significant increase in eye floaters and cobwebs  (hope you get this I don't know what they are called, I've read about them and learned that they could be due to increase in vitreous gel) and lastly 6 months back flashes of light are not so frequent but  regular visitors.other symptoms are pale yellow hue in both the eyes and drying of eyes in air conditioner while sleeping and sensitivity to bright light leading to eye pain. To conclude I am myopic (-5.5 left eye , vision 6/6 or 9 and -6.5 right eye , vision 6/18 or 20).Amblyopic in the right eye.
Finally all this scares to me to a terrific degree. What's going on?!I fear I might be undergoing a eye problem that I may not be aware of but is gradually deepening its roots and I may be missing out on its detection, I visit my optician every 6 months but he says everything's alright, but I doubt...
Please help me and try to reply as soon as possible it would be truly grateful of you.
*an eye problem
You have a multitude of eye problems all of which require an in person examination by an Eye MD ophthalmologist. You should have one an having at a minimum a yearly eye exam. Print out that post and take it in to your Eye MD and go over it with her/him.  I can't tell you anything about specific causes for your problem.  You can use the search feature and read about floaters.
Thank you so much for your generous advice sir.
Best of luck. Hopefully the ophthalmologist will find everything okay.
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