{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T07:51:07Z","timestamp":1774943467828,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T00:00:00Z","timestamp":1314835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T00:00:00Z","timestamp":1314835200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["OVS"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background.<\/jats:title>\n                    <jats:p>\n                      Hereditary hemochromatosis (HH) is a common hereditary disorder that primarily afflicts patients of Northern European descent. A single mutation of the\n                      <jats:italic>HFE<\/jats:italic>\n                      gene results in unregulated dietary iron uptake with the potential to deleteriously affect multiple organ systems including the eye. If HH is suspected, a screening test measuring transferrin saturation is initially obtained. Confirmation of this disorder is accomplished with genetic testing and liver biopsy. Treatment should commence immediately and undergo venesection (phlebotomy) treatments 2 to 4 times a year for the remainder of the patient's life.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report.<\/jats:title>\n                    <jats:p>\n                      The following is a case of a 54\u2010year\u2010old male of Scottish\u2010German descent who was evaluated for a subconjunctival hemorrhage (SCH). A review of the patient's record disclosed that he had 12 previous episodes of SCH over a 10\u2010year period. He was undergoing a comprehensive evaluation for HH due to the recent diagnosis of this condition in his older brother. Hematologic analysis showed that our patient had a serum ferritin level 4 to 5 times higher than normal (1340 \u03bcg\/L) and a homozygous recessive profile of the\n                      <jats:italic>HFE<\/jats:italic>\n                      gene. Once under maintenance venesection therapy, the frequency of the SCH diminished.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>HH must be considered a differential diagnosis in cases of recurrent SCH. Coupled with the recognition of characteristic physical signs and symptoms of HH, hematologic analysis and genetic testing may further aid in diagnosis. With early detection and treatment, the optometrist can make a significant impact on the life expectancy of the patient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/opx.0b013e3182223683","type":"journal-article","created":{"date-parts":[[2011,6,10]],"date-time":"2011-06-10T07:58:41Z","timestamp":1307692721000},"page":"1133-1139","source":"Crossref","is-referenced-by-count":3,"title":["Subconjunctival Hemorrhages: Presenting Sign for Hereditary Hemochromatosis"],"prefix":"10.1002","volume":"88","author":[{"given":"Judy W. H.","family":"Tong","sequence":"first","affiliation":[{"name":"Jarnagin Primary Care Service, Chronic Care Service Eye Care Center Southern California College of Optometry Fullerton California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark H.","family":"Sawamura","sequence":"additional","affiliation":[{"name":"Jarnagin Primary Care Service, Chronic Care Service Eye Care Center Southern California College of Optometry Fullerton California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,9,1]]},"reference":[{"key":"e_1_2_5_2_2","volume-title":"Haemochromatosis","author":"Sheldon JH","year":"1935"},{"key":"e_1_2_5_3_2","first-page":"452","article-title":"Synopsis of the Dutch multidisciplinary guideline for the diagnosis and treatment of hereditary haemochromatosis","volume":"65","author":"Swinkels DW","year":"2007","journal-title":"Neth J Med"},{"key":"e_1_2_5_4_2","first-page":"419","article-title":"Changing aspects of HFE\u2010related hereditary haemochromatosis and endeavours to early diagnosis","volume":"65","author":"Jacobs EM","year":"2007","journal-title":"Neth J Med"},{"key":"e_1_2_5_5_2","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1056\/NEJMoa041534","article-title":"Hemochromatosis and iron\u2010overload screening in a racially diverse population","volume":"352","author":"Adams PC","year":"2005","journal-title":"N Engl J Med"},{"key":"e_1_2_5_6_2","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1093\/aje\/154.3.193","article-title":"HFE gene and hereditary hemochromatosis: a HuGE review. 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