November 27, 2015
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Subconjunctival Hemorrhage (cont.)

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How is a subconjunctival hemorrhage diagnosed?

A health-care provider will take a medical, eye, and medication history to determine what events were leading up to the subconjunctival hemorrhage and will also perform an examination. Blood pressure may also be checked.

If trauma was the cause, a more thorough examination will usually be performed.

In newborn infants, subconjunctival hemorrhage can occasionally be found as a result of the birth process.

What are the risk factors for subconjunctival hemorrhage?

Most subconjunctival hemorrhages are spontaneous and not linked to any specific risk factors. If the hemorrhage is not spontaneous, then the risk factors for subconjunctival hemorrhage include trauma to the eye, eye surgery, the use of contact lenses, the use of medication that inhibits clotting or promotes bleeding, and diseases that are characterized by decreases in platelet count or vascular fragility. Because of the association between increasing vascular fragility and advanced age, being older also includes an increased risk of subconjunctival hemorrhage.

What is the treatment for a subconjunctival hemorrhage?

Usually, no treatment is needed. Over-the-counter artificial tears can be applied to the eye if mild irritation is present. The eye does not require a patch.

The use of aspirin or other medication that inhibits clotting should be avoided. If you are taking aspirin or an anticoagulant for a medical condition, check with your physician to determine whether the medication should be stopped or continued. Do not stop anti-coagulation medicines without physician consultation. These medications are frequently life savers, and they rarely need to be discontinued for a subconjunctival hemorrhage.

If the subconjunctival hemorrhage is trauma-related, an ophthalmologist will determine what other treatment is necessary to promote healing of the injury.

If the subconjunctival hemorrhage is a result of an external infection, an ophthalmologist may prescribe antibiotic drops or an ointment.

This condition clears by itself within one to two weeks. Recovery is usually complete, without any long-term problems, similar to a mild bruise under the skin. Like a bruise, a subconjunctival hemorrhage changes colors (often red to orange to yellow) as it heals. A skin bruise changes to various shades of green, black, and blue as it heals, because the blood is being seen through skin. Because the conjunctiva is transparent, a subconjunctival hemorrhage never has these color characteristics.

Very rarely, with recurrent subconjunctival hemorrhage in the same location in the same eye, there may be an abnormal fragile capillary within the conjunctiva that has thin walls and tends to bleed spontaneously. An ophthalmologist can identify such a condition and close this non-essential blood vessel using heat, either from a laser or a diathermy unit.

Medically Reviewed by a Doctor on 7/20/2015


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