Subconjunctival Haemorrhage

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Findings

  • Usually asymptomatic, may have foreign body sensation
  • Acute ocular redness, often sectorial, may be circular due to subconjunctival haemorrhage 1, 2

Aetiology

  • idiopathic
  • Valsalva manoeuvre
  • Anticoagulants
  • High blood pressure, diabetes
  • Mechanical (traumatic, eye rubbing, contact lenses)
  • others: haematological diseases, topical steroid therapy, secondary to conjunctival lymphoma, amyloidosis, orbital fractures

Work-up

  • Medical history
  • Measure blood pressure
  • Slit lamp examination: isolated haemorrhage or other lesions?
  • If traumatic: rule out an occult globe rupture!
    • in case of recurrent haemorrhages: consider haematological assessment
    • in case of orbital signs (increased IOP, restricted motility, exophthalmos): consider imaging of the orbit to rule out orbital tumours

Therapy

  • Usually none necessary, consider lubricating eye drops
  • Self limiting, disappears within 1-4 weeks (depending on extent)

Sources

  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Kalla Gervasio MD, Travis Peck MD et al; Lippincott Williams&Wilkins; 8th Edition (2021)
  • 1, 2 von Eyerounds.org, © The University of Iowa; Licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License (CC BY-NC-ND 3.0).
    • 1 Contributor: Angela Mahoney; Anthony T. Chung, MD; Audrey C. Ko, MD; Photographer: Audrey C. Ko, MD
    • 2 Contributor: Jesse Vislisel, MD; Photographer: Jody Troyer, CRA
  • Tarlan B, Kiratli H. Subconjunctival hemorrhage: risk factors and potential indicators. Clin Ophthalmol. 2013;7:1163-70. doi: 10.2147/OPTH.S35062. Epub 2013 Jun 12. PMID: 23843690; PMCID: PMC3702240.