This presents as a bright red patch under the conjunctiva following rupture of a small conjunctival vessel. It may arise spontaneously, following slight trauma, or as a result of local congestion due to coughing or sneezing. In head injury, blood from a fracture at the base of the skull may travel through the floor of the orbit and into the subconjunctival space. The condition is usually unilateral. Recurrent or bilateral subconjunctival haemorrhage suggests hypertension or blood dyscrasias.
The conjunctival vascular markings may be obscured. A definable margin is absent if secondary to trauma since the bleeding extends backwards into the orbit. There is no discharge. Usually, the condition is painless and does not usually impair vision.
No local treatment is required. The blood is gradually absorbed, changing from bright red to yellow within 14 days.
Last reviewed 01/2018