Home > Adults > Ophthalmology >

Subconjunctival Haemorrhage

Checked: 23-08-2020 by Vicky Ryan Next Review: 23-08-2021

Overview

This is a bleed beneath the conjunctiva, often the conjunctiva will appear raised with the blood. They can occur spontaneously or with episodes of straining or eye rubbing.

Typically, there is no pain, and vision is unaffected.

Please see diagnostic photograph.

Who to refer

Subconjunctival haemorrhage does not usually require referral. It is self-limiting

Red Flags

Occasionally subconjunctival haemorrhages can be so large that they prevent adequate closure of the eye, in these cases prescribe a thick artificial lubricant ointmentv(e.g. Xailin Night) and advise the patient attend the BEH Emergency Department within 24 hours. Review is to monitor potential corneal exposure, and not for treatment of the subconjunctival haemorrhage.

Consider referral in cases of reduced vision or pain, as this shouldn’t occur with simple subconjunctival haemorrhages.

Before referral

These should self-resolve without treatment. Check the patient’s BP, as very high BP may cause a subconjunctival haemorrhage. Advise it should resolve over the coming 1-2 weeks and if the eye is sore to use artificial lubricants.

Referral

Does not usually need referral - self limiting

Resources

These guidelines have been written by Rhys Harrison, consultant ophthalmologist at Bristol Eye Hospital, with thanks to the patients who have kindly given consent to use their photos.

For full ophthalmology guidelines see: Primary Care Ophthalmology Guidance Document

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.