Subconjunctival bleeding

Subconjunctival bleeding
Other names	Subconjunctival hemorrhage, hyposphagma
Subconjunctival hemorrhage resulting in red coloration of the white of the eye
Specialty	Ophthalmology, Optometry
Symptoms	Red spot over whites of the eye, little to no pain
Complications	None
Duration	One to two weeks
Types	Traumatic, spontaneous
Causes	Coughing, vomiting, direct injury
Risk factors	High blood pressure, diabetes, older age
Diagnostic method	Based on appearance
Differential diagnosis	Open globe, retrobulbar hematoma, conjunctivitis, pterygium
Treatment	No specific treatment
Medication	Artificial tears
Prognosis	Good, 10% risk of recurrence
Frequency	Common

Subconjunctival bleeding, also known as subconjunctival hemorrhage or subconjunctival haemorrhage, is bleeding from a small blood vessel over the whites of the eye. It results in a red spot in the white of the eye.^[1] There is generally little to no pain and vision is not affected.^[2][3] Generally only one eye is affected.^[2]

Causes can include coughing, vomiting, heavy lifting, straining during acute constipation or the act of "bearing down" during childbirth, as these activities can increase the blood pressure in the vascular systems supplying the conjunctiva. Other causes include blunt or penetrating trauma to the eye. Risk factors include hypertension, diabetes, old age, and blood thinners. Subconjunctival bleeding occurs in about 2% of newborns following a vaginal delivery. The blood accumulates between the conjunctiva and the episclera. Diagnosis is generally based on the appearance of the conjunctiva.^[2]

The condition is relatively common,^[4] and both sexes are affected equally. Spontaneous bleeding occurs more commonly over the age of 50 while the traumatic type occurs more often in young males. Generally no specific treatment is required and the condition resolves over two to three weeks. Artificial tears may be used to alleviate irritation.^[2]