A subconjunctival hemorrhage is bleeding below the transparent layer of the eye called the conjunctiva.
Causes
What causes it? Violent sneezing, coughing, vomiting, heavy lifting and minor blunt trauma. People at risk for this condition are those with diabetes, high blood pressure, and those who take blood thinners such as aspirin and coumadin (warfarin). Subconjunctival hemorrhages may sometimes present without a known cause.
Symptoms
The most discomforting aspect of a subconjunctival hemorrhage is its appearance. You may not realize that you have a subconjunctival hemorrhage until you see yourself in the mirror. The blood is tends to be bright red, and is flat, meaning it does not bulge against your eyelids. It is often painless, but one may experience a slight itching sensation. Your vision is not affected.
Evaluation
While subconjunctival hemorrhages are benign, it is important to distinguish it from more serious conditions such as a bloody chemosis which is more likely to bulge, and is associated with rupture of the sclera (white part of the eye), and cavernous sinus thrombosis (blood clot in a blood vessel of the brain). Also, in the setting of trauma, if a subconjunctival hemorrhage is located at the far lateral (toward the ear versus the nose) portion of the eye, it can mean a person has a fracture of the zygomatic arch (cheekbone).
Treatment
No treatment is required. The body will absorb the blood over 10-14 days. Recurring episodes require evaluation for bleeding disorders or uncontrolled high blood pressure.
For this and more information, check out the Mayo Clinic, American Optometric Association websites, and Knoop, Stack, and Storrow's Atlas of Emergency Medicine, 2nd Edition.
Causes
What causes it? Violent sneezing, coughing, vomiting, heavy lifting and minor blunt trauma. People at risk for this condition are those with diabetes, high blood pressure, and those who take blood thinners such as aspirin and coumadin (warfarin). Subconjunctival hemorrhages may sometimes present without a known cause.
Symptoms
The most discomforting aspect of a subconjunctival hemorrhage is its appearance. You may not realize that you have a subconjunctival hemorrhage until you see yourself in the mirror. The blood is tends to be bright red, and is flat, meaning it does not bulge against your eyelids. It is often painless, but one may experience a slight itching sensation. Your vision is not affected.
Evaluation
While subconjunctival hemorrhages are benign, it is important to distinguish it from more serious conditions such as a bloody chemosis which is more likely to bulge, and is associated with rupture of the sclera (white part of the eye), and cavernous sinus thrombosis (blood clot in a blood vessel of the brain). Also, in the setting of trauma, if a subconjunctival hemorrhage is located at the far lateral (toward the ear versus the nose) portion of the eye, it can mean a person has a fracture of the zygomatic arch (cheekbone).
Treatment
No treatment is required. The body will absorb the blood over 10-14 days. Recurring episodes require evaluation for bleeding disorders or uncontrolled high blood pressure.
For this and more information, check out the Mayo Clinic, American Optometric Association websites, and Knoop, Stack, and Storrow's Atlas of Emergency Medicine, 2nd Edition.
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