From the Research
Blood in the sclera of the eye, known as subconjunctival hemorrhage, is typically a benign condition that resolves on its own within 1-2 weeks without treatment. This condition occurs when small blood vessels under the conjunctiva break, allowing blood to leak between the conjunctiva and sclera 1. The most common causes of subconjunctival hemorrhage are trauma and ocular surface inflammation, including infectious conjunctivitis, which together account for 94% to 97% of all cases 1.
Key Points to Consider
- No specific medication is usually needed for subconjunctival hemorrhage, but artificial tears like Refresh or Systane can be applied if the eye feels irritated 1.
- Cold compresses can help reduce any discomfort in the first 24 hours, and it is essential to avoid rubbing the affected eye 1.
- If you take blood thinners or have high blood pressure, continue your medications but consider mentioning this to your doctor, as these conditions may increase the risk of subconjunctival hemorrhage 1.
- While subconjunctival hemorrhage is rarely serious, seek immediate medical attention if the redness is accompanied by pain, vision changes, or follows an injury, as these symptoms may indicate a more severe underlying condition 1.
- Recurrent episodes of subconjunctival hemorrhage warrant medical evaluation to rule out underlying bleeding disorders or hypertension, which can increase the risk of more severe complications 1.
Important Considerations for Patient Care
- A study published in 2022 found that subconjunctival hemorrhage is uncommon in children, with a prevalence of 0.4% in a large cohort of pediatric patients 1.
- The same study found that trauma and inflammation together accounted for 94% to 97% of all cases of subconjunctival hemorrhage in children, highlighting the importance of careful examination to identify other ocular or nonocular signs of trauma 1.
- Another study published in 2020 discussed the lymphangiogenic and hemangiogenic privilege of the human sclera, highlighting the unique vascular characteristics of the sclera and the potential implications for wound healing and disease pathogenesis 2.
Clinical Recommendations
- Subconjunctival hemorrhage is typically a self-limiting condition that does not require specific treatment, but patients should be advised to apply artificial tears and avoid rubbing the affected eye 1.
- Patients with recurrent episodes of subconjunctival hemorrhage or those with underlying bleeding disorders or hypertension should be closely monitored and evaluated to rule out more severe underlying conditions 1.
- In cases where subconjunctival hemorrhage is accompanied by pain, vision changes, or follows an injury, immediate medical attention is necessary to rule out more severe complications 1.