Subconjunctival hemorrhage


  • Bleeding of the conjunctival vessels into the subconjunctival space
  • Can be spontaneous or related to trauma
  • If large and associated with trauma, need to maintain suspicion for occult globe rupture (obscured by hemorrhage)[1]
  • Bilateral and recurrent subconjunctival hemorrhage should have bleeding diathesis workup

Clinical Features

Subconjunctival hemorrhage
Subconjunctival hemorrhage
  • Painless
  • No effect on vision
  • May recall a history of mild trauma or valsalva
  • Examination
    • Fresh red blood on a white sclera with clear borders[1]
    • Masks the conjunctival vessels

Differential Diagnosis

Unilateral red eye

^Emergent diagnoses ^^Critical diagnoses


  • Clinical diagnosis
  • Consider fluorescein staining to evaluate for corneal injury if suggested by history or if patient complains of pain[1]


  • Reassurance (will generally resolve within 10-14d)[1]

See Also


  1. 1.0 1.1 1.2 1.3 Mahmood, Ahmed R., and Aneesh T. Narang. "Diagnosis and management of the acute red eye." Emergency medicine clinics of North America 26.1 (2008): 35-55.