Subconjunctival Hemorrhage

A patient may present with a bright-red eye, normal vision, and no pain. Usually, no obvious cause exists, but in some patients there is a history of coughing, sneezing, or straining before the hemorrhage is present. The patient should be reassured that it is nothing more than hemorrhage of the conjunctiva. There is no therapy, except reassurance that the blood will clear within 2 to 3 weeks. Hematologic blood coagulation studies are usually of limited value in patients with subconjunctival hemorrhages unless there is a history of recurrence. Additionally, it is unusual for a hemorrhage to involve the relatively avascular sclera. If trauma is suspected, the patient should be referred to an ophthalmologist to rule out more serious injuries, such as perforation, contusion, or occult rupture of the globe. Subconjunctival hemorrhage may indicate that the patient is a battered child or adult, and other signs of bodily trauma should be investigated.

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