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Subconjunctival Hemorrhage
Aka: Subconjunctival Hemorrhage, Spontaneous Subconjunctival Hemorrhage
- Pathophysiology
- Bleeding from small Conjunctival vessels
- Causes
- Minor Eye Trauma
- Spontaneously with increased venous pressure
- Coughing
- Sneezing
- Vomiting
- Straining
- Blood dyscrasia (uncommon)
- Warfarin
- Severe Hypertension
- Symptoms
- No Eye Pain
- Vision normal
- Pupil size and reactivity are normal
- Precautions
- Exclude Globe Rupture when Subconjunctival Hemorrhage is Traumatic
- Consider with high velocity projectiles (e.g. grinding)
- Carefully evaluate diffuse Subconjunctival Hemorrhage (circumferential involving full 360 degrees)
- Associated with more serious Eye Trauma (e.g. periorbital Fracture, Retrobulbar Hematoma, Bleeding Disorder)
- Labs
- ProTime (PT/INR)
- Indicated if Subconjunctival Hemorrhage occurs in a patient on Warfarin (Coumadin)
- Management
- Careful exam including vision
- Eye Trauma resulting in bleeding requires an intensive evaluation
- Confirm no signs of Globe Rupture
- Reassurance
- Cold compresses
- Artificial tears
- Referral for question of greater injury (especially if Traumatic Eye Injury)
- Course
- Hemorrhage clears spontaneously in 1-2 weeks
- References
- Dreis (2020) Crit Dec Emerg Med 34(7):3-21