Overview
Subconjunctival haemorrhage (SCH) describes bleeding from a small blood vessel over the sclera of the eye leading to a red spot. It is relatively common and its incidence increases with age as blood vessels in the eye become more fragile.
Causes
The causes of SCH can be divided into:
- Mechanical/traumatic causes:
- Straining, coughing, sneezing, and strangling – can increase the pressure in the blood vessels of the eyes
- Rubbing the eyes
- Foreign bodies
- Non-accidental trauma
- Spontaneous causes:
- Hypertension
- Anticoagulant use
- Coagulopathy
Diagnosis
The diagnosis of SCH is generally clinical. Other investigations to consider are blood pressure measurements and haemostatic testing (such as an INR measurement in those taking warfarin).
Management
Generally, no treatment is necessary. The blood is usually reabsorbed over 1-2 weeks. However, if SCH develops following trauma, then an ophthalmological assessment is appropriate.
