From the Guidelines
Subconjunctival hemorrhages are typically self-limiting and do not require specific treatment, resolving on their own within 1-2 weeks without any intervention. The condition occurs when a small blood vessel breaks under the conjunctiva, causing a bright red patch on the eye. According to a study on anticoagulated patients undergoing elective procedures or surgery 1, ophthalmologic procedures, including those that may result in subconjunctival hemorrhages, have a low risk of major bleeding when patients continue VKA therapy, with most bleeds being self-limiting.
Some key points to consider in managing subconjunctival hemorrhages include:
- Using artificial tears like Refresh or Systane 3-4 times daily for comfort if the eye feels irritated
- Applying cold compresses to reduce mild discomfort in the first 24 hours
- Avoiding rubbing the eye
- Temporarily discontinuing blood thinners only if advised by a doctor, as the risk of thromboembolic outcomes is rare but should be considered on a case-by-case basis 1
It's essential to note that while subconjunctival hemorrhages are usually harmless, they can be caused by minor trauma, coughing, sneezing, straining, or can occur spontaneously. However, if symptoms such as pain, vision changes, recurrent hemorrhages, or a bleeding disorder are present, or if the patient is on blood thinners, consulting an eye doctor is recommended. The body's natural healing process will gradually reabsorb the blood as it breaks down the red blood cells in the conjunctiva.
From the Research
Definition and Management of Subconjunctival Hemorrhage
- Subconjunctival hemorrhage is a commonly presenting clinical problem, usually benign, but can be caused by various entities with important sequelae 2
- A comprehensive work-up is necessary to rule out trauma, infection, medications, or systemic disease as the causative agent 2
Relation to Dry Eye Disease and Artificial Tears
- There is no direct evidence linking subconjunctival hemorrhage to dry eye disease or artificial tears in the provided studies
- However, artificial tears play a critical role in managing dry eye disease, providing symptomatic relief and improving ocular surface health 3, 4, 5
Artificial Tears and Ocular Surface Health
- Artificial tears have a role in corneal abrasion and wound healing, pain and inflammation management, conjunctivitis, keratitis, contact lens rewetting and removal, and foreign body removal 5
- The composition of artificial tears, including ingredients such as viscosity-enhancing agents, electrolytes, osmo-protectants, antioxidants, lipids, surfactants, and preservatives, affects their performance and suitability for specific ocular conditions 3, 4