Subconjunctival hemorrhage

Background

  • Bleeding of the conjunctival vessels into the subconjunctival space
  • Can be spontaneous or related to trauma
    • Spontaneous can be secondary to anticoagulation, bleeding diathesis, etc.
  • 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
  • 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

Evaluation

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

Management

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

See Also

References

  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.