Subconjunctival hemorrhage


  • Bleeding of the conjunctival vessels into the subconjunctival space
  • Can be spontaneous or related to trauma
  • If large and associated with trauma, see hemorrhagic chemosis
  • Bilateral and recurrent subconjunctival hemorrhage should have bleeding diathesis workup

Clinical Features

Subconjunctival hemorrhage
Subconjunctival hemorrhage
Bilateral subconjunctival hemorrhage: (a) at presentation, (b) after 5 days, and (c) complete resolution after 1 month.
  • Painless
  • No effect on vision
  • Frequently atraumatic, although 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
  • Not significantly raised (see hemorrhagic chemosis if large amount raised)

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

External Links


  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.