Trauma

Subconjunctival Hemorrhage

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Subconjunctival Hemorrhage, Spontaneous Subconjunctival Hemorrhage

  • Pathophysiology
  1. Bleeding from small Conjunctival vessels
  • Causes
  1. Minor Eye Trauma
  2. Spontaneously with increased venous pressure
    1. Coughing
    2. Sneezing
    3. Straining
  3. Blood dyscrasia (uncommon)
    1. Warfarin
  4. Severe Hypertension
  • Symptoms
  1. No Eye Pain
  2. Vision normal
  3. Pupil size and reactivity are normal
  • Labs
  1. ProTime (PT/INR)
    1. Indicated if Subconjunctival Hemorrhage occurs in a patient on Warfarin (Coumadin)
  • Management
  1. Careful exam including vision
    1. Eye Trauma resulting in bleeding requires an intensive evaluation
    2. Confirm no signs of Globe Rupture
  2. Reassurance
  3. Cold compresses
  4. Referral for question of greater injury (especially if Traumatic Eye Injury)
  • Course
  1. Hemorrhage clears spontaneously in 1-2 weeks