Evaluating Paediatric Subconjunctival Haemorrhage! Reassurance vs. Referral

Abstract

The vibrant red spots caused by subconjunctival haemorrhage can look scary to onlookers, parents and the child itself. But most cases don’t cause any other symptoms or need treatment. They typically go away on their own within a few weeks. A subconjunctival haemorrhage following a minor eye injury in children is a benign, harmless condition that resolves on its own without medical treatment. The condition occurs when tiny, delicate blood vessels beneath the conjunctiva rupture, causing blood to pool on the sclera. There is no treatment that will help subconjunctival haemorrhage. The only thing that will help is “tincture of time” – that is simply waiting and letting the eye re-absorb the blood trapped between these layers. Other than the red spot in the eye, there are no other symptoms in subconjunctival haemorrhage. It doesn’t cause pain or swelling, and it doesn’t affect your vision. Most people who have a subconjunctival haemorrhage don’t even know it until they look in a mirror or someone tells them. There’s a chance some children could have mild irritation, but there should be no discharge or any other symptoms.
Materials and Method: A 6-year-old girl was brought to this author on the evening of 27 August 2026 around 2000 hrs, with a complaint of bleeding / red patch in the left eye, following an injury during playing basketball fifteen minute ago. The girl felt she thrust her own finger and nails in her left eye while trying to catch & throw the ball. She was crying for last half an hour and resisting to go to any doctor. There was a bit of irritation and tears in the eye. She was frightened and crying. After some consolation and cold pack on the eye she was brought to me. Physical examination under the torch of mobile phone, showed a bright red spot on the sclera outside of the left eye. There were tear drops. Vision was not at all affected for finger count or colours. The right eye was normal.
Outcome: Having counselled that there is nothing serious and it would resolve in 2-3 weeks on its own over next 15-20 days, changing colour from red to brown, pale yellow. For immediate relief parents were advised i) place ice or a frozen pack inside a clean cloth or towel and put it on the closed hurt eye, and not to put ice directly on your skin or eyelid ii) Keep the cold compress on the closed eye for 10 to 15 minutes at a time, several times a day iii) After 2 days, a gentle warm compress to help the body reabsorb the trapped blood. She is being monitored and complication on day 2. As the author revised this article on 10th September the SCH is fully resolved leaving faint yellowish stain.