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Subconjunctival bleeding, also known as subconjunctival hemorrhage or subconjunctival haemorrhage, is bleeding from a small blood vessel over the whites of the eye. It results in a red spot in the white of the eye. [1] There is generally little to no pain and vision is not affected. [2] [3] Generally only one eye is affected. [2]
Conjunctivitis and subconjunctival hemorrhage are two of the less serious but more common causes. Management includes assessing whether emergency action (including referral) is needed, or whether treatment can be accomplished without additional resources.
A subconjunctival hemorrhage can often occur without any obvious cause or harm to the eye. A strong enough sneeze or cough can cause a blood vessel in the eye to burst. Hyphema is a result of blunt or penetrating trauma to the orbit that increases intraocular pressure, causing tears in the vessels of the ciliary body and iris .
It typically serves to provide lubrication for the eye through the production of mucus and tears. When infected with AHC, patients will experience painful, red eyes, swelling of the conjunctival tissue, and frequent mucus discharge from the eyes accompanied by excessive tearing and subconjunctival hemorrhaging.
Secondary hemorrhage, or rebleeding of the hyphema, is thought to worsen outcomes in terms of visual function and lead to complications such as glaucoma, corneal staining, optic atrophy, or vision loss. [1] Rebleeding occurs in 4–35% of hyphema cases and is a risk factor for glaucoma. [4]
Bruises often induce pain immediately after the trauma that results in their formation, but small bruises are not normally dangerous alone. Sometimes bruises can be serious, leading to other more life-threatening forms of hematoma, such as when associated with serious injuries, including fractures and more severe internal bleeding .
Depending on the location and extent of the bleeding, valsalva retinopathy usually resolves within weeks to months, without any complications. [4] Patients are instructed to avoid anticoagulant drugs and physical activities which cause increase in intrathoracic or intra-abdominal pressure. [4]
The goal of the treatment is to fix the cause of the hemorrhage as quickly as possible. Retinal tears are closed by laser treatment or cryotherapy, and detached retinas are reattached surgically. [6] Even after treatment, it can take months for the body to clear all of the blood from the vitreous. [2]