Hello! Welcome to case of the day, I’m Dr. Croley. Today we’re gonna discuss an interesting case that we see fairly common in the office. A lady called up late last night and we end up seeing her first thing early in the morning at 7:30 who complained of a sudden red eye. And we get these phone calls fairly often. People get really concerned about it because of many cases of how bad their eye looks. Over the phone you’ll never know what for sure they’re describing but in this case she said her eye was red and she was having maybe some slight irritation but she was excited and really wasn’t clear about how her eye was really giving her any trouble other than what she saw in the mirror. So she came in this morning and we took a look at her and she has what is called a subconjunctival hemorrhage. So these are pretty common and fortunately in almost all cases, don’t cause any problems and don’t really give us any trouble and there’s really no treatment that we have to do, but they can look very bad.
So what is a subconjunctival hemorrhage? So if we look at the eye, the white part of your eye is called the sclera. And over top of the sclera sits another tissue or membrane called the conjunctiva which contains a lot of blood vessels and this conjunctiva is sort of loosely attached to the sclera it does move around some, and it contains a lot of blood vessels. So when people get an eye infection, which she thought she might have an eye infection because her eye was red. These blood vessels get enlarged and your eye turns red with an eye infection but it’s not blood; it’s actually the blood vessels have enlarged from the inflammation, from the infection.
So in this particular case, what happens with a conjunctival hemorrhage or subconjunctival hemorrhage is that probably she rubbed her eye at some point or maybe even at sleep and when she did, she broke the blood vessels on the surface of the eye and then it bleeds underneath that coating and just can spread around the white part of the eye and hers was not severely bad and probably in about a week it will go away. But we do have some people who come in with very large subconjunctival hemorrhages especially people who are on Coumadin whose blood is very thin so when they have a hemorrhage you see they got bruises easily they get very large subconjunctival hemorrhages.
And in those cases sometimes they can get so large that they can actually, the conjunctiva, bulges forward and creates a valley where the cornea start and that area can dry out. So they can get eye irritation till the blood starts to resolve and go away. And so in those cases we put people in artificial tears to keep their eyes lubricated and make sure they refer them back to their doctor to make sure that their Coumadin levels are correct, that their blood is not too thin.
Also people who are on aspirin or other things that thin the blood tend to get more of this subconjunctival hemorrhages and they tend to be a little larger or more severe than someone who is not on any type of blood thinners. The only thing that you would have to make sure that is okay in someone like this is that if someone’s blood pressure is highly elevated, that could possibly cause or contribute to having a subconjunctival hemorrhage and so if you have that, it’s good to make sure that your blood pressure is okay. And unless these were a chronic, kept recurring type thing there’s really nothing else that needs to be done. If they are continuously recurring, recurring, recurring, then you need to refer to your medical doctor to make sure that you don’t have a bleeding problem or some blood problem or dysplasia that is going on that would be causing you to bleed easily. But routinely these things are benign. They can look very bad depending on how much blood is on the conjunctiva. They can go away in a week or so, sometimes more than two weeks or so if they are very large. But the good thing is almost always they are benign.
So if you have any questions about subconjunctival hemorrhages or any other questions you can contact us through the website, if not may God bless you with healthy eyes and great vision.