Subconjunctival Hemorrhage,Conjunctival Laceration,

Lid Lacerations

Veranika Darmidy, dr

Subconjunctival Hemorrhage

Subconjunctival Hemorrhage

• Subconjunctival hemorrhage is defined as blood between the conjunctiva and the sclera

• Very common after blunt trauma (also spontaneously in adults, not kids)

• Subconjunctival hemorrhage results from bleeding of the conjunctival or episcleral blood vessels into the subconjunctival space

Anatomy

• The hemorrhage can be traumatic, spontaneous, or related to systemic illness

• History findings may include red eye and possibly mild irritation; however, patients usually are asymptomatic

• No specific treatment required, reassure, most resolve within two weeks.

Subconjunctival Hemorrhage

Conjunctival Laceration

Conjunctival Laceration• History of ocular trauma.• May need fluorescein stain to show a subtle tear.• Often see associated conjunctival hemorrhage.• Do complete ocular exam (consider Ophthalmology

consult) exclude scleral laceration, ruptured globe, conjunctival or intraorbital Foreign Body

• Apply antibiotic ointment and pressure patch 24 hours.• Large lacerations (>1.5 cm) may need sutures (by

ophthalmologist), but most heal without them.

Lid Lacerations

Lid Lacerations

• Sharp or blunt trauma, from eyeglass lens.• Symptoms: pain, bleeding around eye.• Exam: Depth of penetration and location

(middle one third may involve lacrimal system)

• Complete ocular exam – globe rupture.

Lid Lacerations - Treatment

• Clean (betadine), local anesthetic, irrigate with saline, explore for FB, topical anesthetic and eye shell, repair with 5-0 absorbable suture, antibiotic ointment BID.

• Refer to Ophthalmology if the lid margin involved (may get notch), canaliculus involved (may need tear duct stent), or extends into subcutaneous fat.