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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.
The underlying pathology originates in the brain and usually involves an intracranial hemorrhage, such as a subarachnoid hemorrhage (SAH), or several types of elevated intracranial pressure. The abrupt increase in intracranial pressure causes the condition, which is then communicated to the eyes through the optic nerve sheath.
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 .
Symptoms range from dry eye, epiphora and irritation to localized pain, foreign body sensation, subconjunctival hemorrhage and ulceration. Symptoms are often made worse by vigorous blinking. Symptoms are often made worse by vigorous blinking.
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]
Purtscher's retinopathy was first characterized in 1910 and 1912 as a syndrome of sudden blindness after head trauma, [7] with patches of hemorrhage and whitening of the retina in both eyes. [3] Later, it was discovered to occur after other types of trauma, such as chest trauma, and is associated with several non-traumatic systemic diseases. [3]
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.