Subconjunctival bleeding


Subconjunctival bleeding, also known as subconjunctival hemorrhage, is bleeding from a small blood vessel over the whites of the eye. It results in a red spot in the white of the eye. There is generally little to no pain and vision is not affected. Generally only one eye is affected.
Causes can include coughing, vomiting, heavy lifting, and direct injury including that from wearing contact lenses. Risk factors include high blood pressure, diabetes, older age, blood thinners, and trauma including that from wearing contact lenses. They occur in about 2% of newborns following a vaginal delivery. The blood occurs between the conjunctiva and the episclera. Diagnosis is generally based on the appearance.
Generally no specific treatment is required and the condition improves in two to three weeks. Artificial tears may be used to help with any irritation. They occur relatively commonly. Both sexes are affected equally. Spontaneous bleeding occurs more commonly over the age of 50 while the traumatic type occurs more often in young males.

Signs and symptoms

A subconjunctival bleeding usually does not result in pain, although occasionally the affected eye may feel dry, rough, or scratchy.
A subconjunctival bleeding initially appears bright-red underneath the transparent conjunctiva. Later, the bleeding may spread and become green or yellow as the hemoglobin is metabolized. It usually disappears within 2 weeks.

Causes

Subconjunctival bleeding in infants may be associated with scurvy, abuse or traumatic asphyxia syndrome.
Eye surgery such as LASIK, and atmospheric pressure changes such as those from diving deeply in water and aircraft altitude changes.

Diagnosis

Diagnosis is by visual inspection, by noting the typical finding of bright red discoloration confined to the white portion of the eye.

Management

A subconjunctival bleeding is typically a self-limiting condition that requires no treatment unless there is evidence of an eye infection or there has been significant eye trauma. Artificial tears may be applied four to six times a day if the eye feels dry or scratchy. The elective use of aspirin is typically discouraged.