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Subconjunctival hemorrhage
Classification and external resources
ICD-10 H11.3
ICD-9 372.72
A subconjunctival hemorrhage is a common and relatively minor post-LASIK complication.
A large spontaneous subconjunctival hemorrhage of the left eye with patient looking to the left

A subconjunctival hemorrhage (or subconjunctival haemorrhage) is bleeding underneath the conjunctiva. The conjunctiva contains many small, fragile blood vessels that are easily ruptured or broken. When this happens, blood leaks into the space between the conjunctiva and sclera.

Whereas a bruise typically appears black or blue underneath the skin, a subconjunctival hemorrhage initially appears bright red underneath the transparent conjunctiva. Later the hemorrhage may spread and become green or yellow, like a bruise. Usually this disappears within 2 weeks. [1]

Although its appearance may be alarming, a subconjunctival hemorrhage is generally a painless and harmless condition; however, it may be associated with high blood pressure, trauma to the eye, or a base of skull fracture if there is no posterior border of the hemorrhage visible.

Causes

  • Minor eye trauma
  • Spontaneously with increased venous pressure

Leptospirosis

  • LASIK
  • Blood thinners, such as ginger, capsaicin, ginseng, garlic, aspirin, or Herba if taken in high doses or combined. These can also make the vessels in the eye more susceptible to the pressure causes listed above.
  • Diving accidents-Mask Squeeze (volume inside in mask creates increased pressure with increased depth)
  • Severe thoracic trauma, leading to increased pressure in the extremities, including around the eyes.

Subconjunctival hemorrhages in infants may be associated with scurvy (a vitamin C deficiency)[2],[3], abuse or traumatic asphyxia syndrome [4].

Treatment and management

A subconjunctival hemorrhage is typically a self-limiting condition that requires no treatment in the absence of infection or significant trauma. The elective use of aspirin and NSAIDs is typically discouraged.

A common symptom of a subconjunctival hemorrhage, itchy eyes, is often treated by applying eye drops or artificial tears to the affected eye(s), however, this is discouraged, as it may slow down the healing process.

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