MDT EYE conjunctival hemorrhage

Question 1

What is the thin and clear mucous membrane covering most of the anterior surface of the eye and eyelid.

Answer 1

Conjunctiva

Question 2

What are some Etiology for a conjunctival hemorrhage

Answer 2

(a) Valsalva (e.g., coughing, sneezing, vomiting, bearing down with constipation,
or other forms of straining).
(b) Traumatic: Can be isolated or associated with a retrobulbar hemorrhage or ruptured globe.
(c) Hypertension and diabetes.
(d) Bleeding disorder.
(e) Antiplatelet or anticoagulant medications (aspirin, warfarin).
(f) Topical steroid therapy.
(g) Hemorrhage due to orbital mass (rare).
(h) Idiopathic.

Question 3

What would you suspect?
Symptoms: Red eye, foreign body sensation, usually asymptomatic unless there is associated chemosis.

Signs: Blood underneath the conjunctiva, often in one sector of the eye. The entire view of the sclera can be obstructed by blood

Answer 3

conjunctival hemorrhage

Question 4

What are some ddx for conjunctival hemorrhage?

Answer 4

(1) Conjunctivitis (injection, discharge)
(2) Scleritis (inflammation of sclera results in dark red, purple, or blue color)
(3) Conjunctival laceration
(4) Foreign body
(5) Open globe

Question 5

Labs/Studies/EKG: for conjunctival hemorrhage?

Answer 5

(1) Complete eye examination
(2) Laboratory bleeding studies (if recurrent)
(3) CT or MRI (if orbital signs are present)

Question 6

Treatment for conjunctival hemorrhage

Answer 6

(1) None required (usually clears spontaneously within 2 to 3 weeks)
(2) Artificial tear drops QID (for irritation)

Question 7

True/False
Follow up if the blood does not fully resolve or if they experience a recurrence. Referral indicated for hypertension or a bleeding diathesis

Answer 7

True

Question 8

True/False
Patients with an isolated conjunctival injury typically recover fully without any
vision loss.

Answer 8

True