Treatment of Subconjunctival Hemorrhage
Subconjunctival hemorrhage requires no specific treatment beyond observation and reassurance, as it typically resolves spontaneously within 1-2 weeks without intervention. 1
Understanding Subconjunctival Hemorrhage
- Subconjunctival hemorrhage is a benign condition characterized by bleeding under the conjunctiva, causing a bright red appearance on the white of the eye 2
- It is a common cause of acute ocular redness that usually resolves without treatment 2
- The condition may appear alarming to patients but rarely affects vision or causes discomfort 3
Management Approach
Primary Treatment
- Observation is the standard treatment as most cases resolve spontaneously within 1-2 weeks 1, 3
- No specific medication or intervention is typically required 3
- Patient reassurance about the benign nature of the condition is important 3
Supportive Measures (if needed)
- Artificial tears or lubricants may provide comfort if mild irritation is present 1
- Cold compresses may help reduce any minor discomfort in the acute phase 3
- Avoiding eye rubbing to prevent further bleeding 2
Special Considerations
Recurrent Subconjunctival Hemorrhages
- Recurrent episodes warrant further evaluation for underlying causes 2
- Consider assessment for:
Conjunctivochalasis and Subconjunctival Hemorrhage
- Moderate to severe conjunctivochalasis is associated with recurrent subconjunctival hemorrhages 6
- Surgical correction of conjunctivochalasis may be considered in patients with frequent recurrences (>80% success rate in preventing further episodes) 6
When to Refer
- Persistent hemorrhage beyond 2-3 weeks 2
- Recurrent episodes (three or more) 6
- Associated symptoms such as pain, vision changes, or discharge 3
- Suspected underlying systemic disease 2
Risk Factors to Assess
- Trauma and contact lens use (more common in younger patients) 2
- Systemic vascular diseases including hypertension, diabetes, and arteriosclerosis (more common in elderly) 2
- Activities requiring visual concentration (watching screens, reading, driving) 6
- Use of blood thinners or anticoagulants 5
Clinical Pearls
- Despite its dramatic appearance, subconjunctival hemorrhage is typically harmless and self-limiting 3
- The condition does not usually require laboratory testing unless recurrent or associated with other bleeding manifestations 4
- Routine hemostatic screening is not indicated for isolated subconjunctival hemorrhage 4
- Patient education about the benign nature of the condition is essential to reduce anxiety 3