From the Research
Subconjunctival hemorrhages with no other symptoms typically require no specific treatment as they resolve spontaneously within 1-2 weeks. Patients should be reassured about the benign and self-limiting nature of this condition. Artificial tears such as carboxymethylcellulose or polyvinyl alcohol drops can be used 4-6 times daily if mild irritation is present 1. Cold compresses may be applied to the affected eye for 10 minutes several times a day during the first 24 hours to reduce any discomfort. Patients should avoid rubbing the eye and discontinue blood thinners only if medically advised. If the patient wears contact lenses, they should temporarily switch to glasses until the hemorrhage resolves.
Some key points to consider in the management of subconjunctival hemorrhage include:
- The risk factors for subconjunctival hemorrhage, which include trauma, contact lens usage, systemic vascular diseases such as hypertension, diabetes, and arteriosclerosis 1
- The potential for subconjunctival hemorrhage to be a presenting feature of underlying systemic conditions, such as idiopathic thrombocytopenic purpura 2
- The importance of monitoring for complications, such as recurrent or persistent hemorrhage, which may require further evaluation and treatment 3
Medical attention should be sought if the hemorrhage doesn't resolve within 2-3 weeks, recurs frequently, is accompanied by pain, vision changes, or occurs after trauma. The hemorrhage results from spontaneous rupture of small blood vessels in the conjunctiva, with blood trapped between the conjunctiva and sclera, appearing as a bright red patch that gradually changes to yellow-green as it resolves. It is worth noting that while some studies have reported associations between subconjunctival hemorrhage and certain medications, such as warfarin 4 and aspirin 5, the current evidence does not support a specific treatment approach based on these associations. Instead, management should focus on supportive care and monitoring for potential complications.