Subconjunctival Haemorrhage

Question 1

What is the pathophysiology of a subconjunctival haemorrhage?

Answer 1

A small blood vessel in the conjunctiva ruptures and releases blood into the space between the sclera and the conjunctiva.

Question 2

What commonly causes subconjunctival haemorrhage?

Answer 2

Episodes of strenuous activity - coughing, weight-lifting, straining whilst constipated.

Question 3

What conditions are associated with subconjunctival haemorrhage?

Answer 3

1. Hypertension
2. Bleeding disorders (e.g. thrombocytopenia)
3. Whooping cough
4. Medications (e.g. warfarin, NOACs, antiplatelets)
5. Non-accidental injury

Question 4

What is this a presentation of:
Patch of bright red blood underneath conjunctiva covering the white of the eye, painless, no vision loss, history of precipitating event?

Answer 4

Subconjunctival haemorrhage

Question 5

What is the treatment for subconjunctival haemorrhage?

Answer 5

1. Resolves spontaneously without treatment, takes around 2 weeks.
2. Treat possible underlying causes
3. Lubricating eye drops if there is foreign body sensation.