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Subconjunctival Hemorrhage (Red Eye) : Causes,Diagnosis,Treatment,Management

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What is Subconjunctival Hemorrhage ? 
The name says it all : simply put its bleeding ( or collection of blood ) below the conjunctiva.


What is "Conjunctiva" ?
Its the thin,transparent,moist membrane which is the outermost covering of the eye.Its blood vessels are very fragile and thus can easily rupture.

What does the patient complain of ? ( SYMPTOMS )
  • Red Eye ( blood collects between the conjunctiva and the white of the eye - sclera )
  • may be assosciated with itchy eyes
  • Usually asymptomatic
What the doctor should observe ? ( SIGNS )
Blood underneath the conjunctiva,often in one sector of the eye.
Sometimes the entire view of the white of the eye (sclera) can be obstructed by blood.

What Causes Subconjunctival hemmorhage ?
  • Trauma : most common cause
  • coughing,sneezing,constipation,epileptic fits,strangulation : these cause sudden venous congestion of the head leading to subconjunctival hemorhage
  • inflammation of the conjunctiva : which may be caused by bacterial or viral infections
  • Hypertension
  • Blood dyscrasias : like anemias , luekaemias
  • Bleeding disorders : like hemophilia
  • Antiplatelet or anticoagulant medications : like aspirin,clopidogrel,warfarin
  • in some cases,the cause is unknown
" But doc, my eye looks really scary " !!!
Yeah , sure it does...but rest assured..,its usually a harmless condition.

    Subconjunctival hemorrhage in the process of healing ( being absorbed )
              
What is the treatment for subconjunctival hemorrhage ?
  • there is no specific treatment,the accumulated blood slowly gets reabsorbed in 7-21 days. ( so now u can guess how "scary" red eye really is )
  • Reassuring the patient forms the most important part of the treatment. 
DONT's :  - use medications like aspirin,clopidogrel as these may aggravate bleeding ( if you do use them for  other medical ailments then do consult with your healthcare specialist )
            - since the eyes may be itchy,artificial tears may be prescribed but some argue it may delay or interfere with the natural healing process.
Do's :   - if a specific underlying cause is discovered then it must be treated.
           - in case of assosciated infection of the conjunctiva , antibiotic eye drops are prescribed.

Notes for the Doc - Remember to : 

  1. Ask for history of  eye rubbing,trauma,severe cough,medications used,bleeding or clotting disorders.
  2. Ask whether this has frequently happened before.
  3. And plz do check the Blood pressure !!


Have you suffered from Red Eye , what was your experience , what do you think you should or should not have done ,what queries would you have liked to ask..please feel free to share and comment 



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