Clinical Cases in Eye Care by Rosenfield Mark;

Author:Rosenfield, Mark;
Language: eng
Format: epub
Publisher: Wolters Kluwer
Published: 2018-09-15T00:00:00+00:00

Comments

John was diagnosed with a subconjunctival hemorrhage and traumatic iridocyclitis in the right eye. He was reassured that although the hemorrhage appeared severe, it would resolve completely without treatment in approximately 2 weeks. The importance of protective eyewear for sporting activities was emphasized to prevent future injury to the eyes and surrounding tissue. The uveitis was treated with 1 drop of atropine in the right eye, which was administered in office. John was also prescribed topical prednisolone acetate 1% for the right eye with an initial dosage of 4 times a day for 1 week. This was followed by a gradual taper to 1 drop daily over the following 3 weeks. His intraocular pressures were measured weekly and remained stable throughout the course of treatment. The subconjunctival hemorrhage had resolved completely at a 2-week follow-up examination, and the uveitis had resolved by the third week after the injury.

Discussion

A subconjunctival hemorrhage often occurs following blunt trauma to the globe. However, other potential causes include mechanical rubbing of the eye, intraocular surgery or injections, and contact lens wear.1 Patients using blood thinning medications or supplements that increase the risk of bleeding are more likely to develop a subconjunctival hemorrhage. In some cases, the hemorrhage can occur in association with an infection or tumor of the conjunctiva.1,2 The accumulation of blood from ruptured capillaries between the clear conjunctival tissue and episclera can also result from the Valsalva maneuver, vomiting, coughing or sneezing, vascular disease or blood-clotting disorders (Figure 2.26-1).

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