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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]
A subconjunctival hemorrhage can often occur without any obvious cause or harm to the eye. A strong enough sneeze or cough can cause a blood vessel in the eye to burst. Hyphema is a result of blunt or penetrating trauma to the orbit that increases intraocular pressure, causing tears in the vessels of the ciliary body and iris .
Symptoms range from dry eye, epiphora and irritation to localized pain, foreign body sensation, subconjunctival hemorrhage and ulceration. Symptoms are often made worse by vigorous blinking. Symptoms are often made worse by vigorous blinking.
Conjunctivitis and subconjunctival hemorrhage are two of the less serious but more common causes. Management includes assessing whether emergency action (including referral) is needed, or whether treatment can be accomplished without additional resources.
Secondary hemorrhage, or rebleeding of the hyphema, is thought to worsen outcomes in terms of visual function and lead to complications such as glaucoma, corneal staining, optic atrophy, or vision loss. [1] Rebleeding occurs in 4–35% of hyphema cases and is a risk factor for glaucoma. [4]
Persistent vision impairment can cause problems carrying out daily tasks, which might lower one's quality of life or cause psychological suffering like anxiety or depression. In certain instances, vision may return to almost normal levels as the blood in the eye gradually clears itself without the need for major treatment.
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Then comes the more characteristically described extreme and sustained upward deviation of the eyes. In addition, the eyes may converge, deviate upward and laterally, or deviate downward. The most frequently reported associated findings are backwards and lateral flexion of the neck, widely opened mouth, tongue protrusion, and ocular pain.