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Subconjunctival Hemorrhages

By Melvin I. Roat, MD, FACS, Clinical Associate Professor of Ophthalmology; Cornea Service, Sidney Kimmel Medical College at Thomas Jefferson University; Wills Eye Hospital

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Subconjunctival hemorrhages are extravasations of blood beneath the conjunctiva.

Subconjunctival hemorrhages usually result from minor local trauma, straining, sneezing, or coughing; rarely, they occur spontaneously. The extent and location of hyperemia can help determine etiology. Diffuse hyperemia of the bulbar and tarsal conjunctivae is typical of conjunctivitis. Subconjunctival hemorrhages alarm the patient but are of no pathologic significance except when associated with blood dyscrasia, which is rare, or facial or ocular injuries. They are absorbed spontaneously, usually within 2 wk. Topical corticosteroids, antibiotics, vasoconstrictors, and compresses do not speed reabsorption; reassurance is adequate therapy.

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