eMedicine Specialties > Ophthalmology > Conjunctiva

Subconjunctival Hemorrhage: Differential Diagnoses & Workup

Author: Robert H Graham, MD, Senior Associate Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona
Coauthor(s): Vivian Monsanto, MD, Consulting Staff, The Mackool Eye Institute and Laser Center; Norvin Perez, MD, Clinical Assistant Professor of Emergency Medicine, Albert Einstein College of Medicine; Consulting Staff, Department of Emergency Medicine, Montefiore Medical Center
Contributor Information and Disclosures

Updated: Feb 3, 2009

Differential Diagnoses

Conjunctivitis, Acute Hemorrhagic
Kaposi Sarcoma
Red Eye Evaluation

Other Problems to Be Considered

Other conjunctival neoplasms with secondary hemorrhage

Workup

Laboratory Studies

  • Usually, no laboratory studies are indicated.
    • Check blood pressure.
    • If history of trauma, rule out ruptured globe or retrobulbar hemorrhage.
    • In recurrent cases or if history of bleeding problems (eg, epistaxis, easy bruising), a bleeding time, prothrombin time/activated partial thromboplastin time (PT/aPTT), CBC with platelets, and protein C and S should be obtained with consideration for consultation to an internist.

More on Subconjunctival Hemorrhage

Overview: Subconjunctival Hemorrhage
Differential Diagnoses & Workup: Subconjunctival Hemorrhage
Treatment & Medication: Subconjunctival Hemorrhage
Follow-up: Subconjunctival Hemorrhage
References

References

  1. American Academy of Ophthalmology. External disease and cornea. In: Basic and Clinical Science Course. Vol 8. American Academy of Ophthalmology; 1995:292.

  2. Bodack MI. A warfarin-induced subconjunctival hemorrhage. Optometry. Mar 2007;78(3):113-8. [Medline].

  3. Fraunfelder FT. Drug Induced Ocular Side Effects and Drug Interactions. 3rd ed. Philadelphia: Lea & Febiger; 1989.

  4. Friberg TR, Weinreb RN. Ocular manifestations of gravity inversion. JAMA. Mar 22-29 1985;253(12):1755-7. [Medline].

  5. Knopf HL, Carter K, Prokopius MJ. Recurrent subconjunctival hemorrhage. Compr Ophthalmol Update. May-Jun 2006;7(3):155-6. [Medline].

  6. Pong JC, Lam DK, Lai JS. Spontaneous subconjunctival haemorrhage secondary to carotid-cavernous fistula. Clin Experiment Ophthalmol. Jan-Feb 2008;36(1):90-1. [Medline].

  7. Quezada AA, Shields CL, Wagner RS, Demirci H, Caputo AR, Shields JA. Lymphangioma of the conjunctiva and nasal cavity in a child presenting with diffuse subconjunctival hemorrhage and nosebleeds. J Pediatr Ophthalmol Strabismus. May-Jun 2007;44(3):180-2. [Medline].

  8. Rhee DJ. Subconjunctival hemorrhage. In: Wills Eye Manual: Office & Emergency Room Diagnosis & Treatment of Eye Disease. 3rd ed. Lippincott Williams & Wilkins; 1999:130-131.

  9. Russell SR, Olsen KR, Folk JC. Predictors of scleral rupture and the role of vitrectomy in severe blunt ocular trauma. Am J Ophthalmol. Mar 15 1988;105(3):253-7. [Medline].

  10. Shields SR. Managing eye disease in primary care. Part 2. How to recognize and treat common eye problems. Postgrad Med. Oct 2000;108(5):83-6, 91-6. [Medline].

  11. Spitzer SG, Luorno J, Noël LP. Isolated subconjunctival hemorrhages in nonaccidental trauma. J AAPOS. Feb 2005;9(1):53-6. [Medline].

  12. van Heuven WAJ. Subconjunctival hemorrhage. In: Decision Making in Ophthalmology: An Algorithmic Approach. Mosby-Year Book; 2000:66-67.

  13. Wirbelauer C. Management of the red eye for the primary care physician. Am J Med. Apr 2006;119(4):302-6. [Medline].

Further Reading

Keywords

subconjunctival hemorrhage, red eye, bleeding in eye, blood in eye

Contributor Information and Disclosures

Author

Robert H Graham, MD, Senior Associate Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona
Robert H Graham, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and Arizona Ophthalmological Society
Disclosure: WebMD/eMedicine Salary Employment

Coauthor(s)

Vivian Monsanto, MD, Consulting Staff, The Mackool Eye Institute and Laser Center
Vivian Monsanto, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Norvin Perez, MD, Clinical Assistant Professor of Emergency Medicine, Albert Einstein College of Medicine; Consulting Staff, Department of Emergency Medicine, Montefiore Medical Center
Norvin Perez, MD is a member of the following medical societies: American College of Emergency Physicians and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Kilbourn Gordon III, MD, FACEP, Urgent Care Physician
Kilbourn Gordon III, MD, FACEP is a member of the following medical societies: American Academy of Ophthalmology and Wilderness Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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