Subconjunctival hemorrhage

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Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

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Subconjunctival hemorrhage
• No vision change, significant eye pain or light sensitivity, blood behind the cornea, unequal pupils, sign of a penetrating injury, or bruising or bleeding elsewhere
• Reassurance given, since it fades on its own
• Follow up as needed

A subconjunctival hemorrhage is a bruise on the white of the eye from a small broken blood vessel. It does not affect vision, is not painful, and fades over about 2 weeks, changing from red to yellow as it heals. No treatment is needed other than comfort measures. Return precautions given including vision change, eye pain, sensitivity to light, new or spreading redness, discharge, swelling, bruising or bleeding elsewhere, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Cause: cough or vomiting, rubbing or scratch, minor trauma, newborn, none
Reassuring eye exam
Vision change, hyphema, unequal pupils, severe pain need urgent care
Fluorescein without abrasion
Reassurance; resolves without treatment
Course: fades over 2 weeks

Return precautions in the template

vision changeeye painsensitivity to lightnew or spreading rednessdischargeswellingbruising or bleeding elsewhere

Sources

Cribsiders #38 Ophthalmology in Pediatrics (Nov 10, 2021)
Cribsiders #153 Say Cheese! Eye Spy Retinoblastoma (Sept 24, 2025)
American Academy of Ophthalmology Cornea/External Disease Committee. Conjunctivitis Preferred Practice Pattern 2023. Ophthalmology 2024
HC Umbilical Hernia (Chang, AAP Section on Surgery)
AAP Policy Statement, Visual System Assessment in Infants, Children, and Young Adults by Pediatricians. Donahue SP, Baker CN; COPAM, Section on Ophthalmology, AAPOS,…
AAP Clinical Report, Procedures for the Evaluation of the Visual System by Pediatricians. Donahue SP, Baker CN. Pediatrics 2016;137(1):e20153597. Reaffirmed February…
AAP Clinical Report, Hearing Assessment in Infants, Children, and Adolescents: Recommendations Beyond Neonatal Screening. Bower C, Reilly BK, Richerson J, Hecht JL;…
Wang KS; COFN; Section on Surgery. Assessment and Management of Inguinal Hernia in Infants. Pediatrics 2012;130(4):768. Reaffirmed May 2021. (re-read Oct 22 2026,…

Few formal guidelines cover this topic, so the template also leans on expert opinion.