Subconjunctival Hemorrhage

Extensive bleeding under the conjunctiva (Fig. 4.4) frequently occurs with conjunctival injuries (for obtaining a history in trauma cases, see Chapter 18, conjunctival laceration). Subconjunctival hemorrhaging will also often occur spontaneously in elderly patients (as a result of compromised vascular structures in arteriosclerosis), or it may occur after coughing, sneezing, pressing, bending over, or lifting heavy objects. Although these findings are often very unsettling for the patient, they are usually harmless and resolve spontaneously within two weeks. The patient's blood pressure and coagulation status need only be checked to exclude hypertension or coagulation disorders when subconjunctival hemorrhaging occurs repeatedly.

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