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Subconjunctival Hemorrhage: Free MSRA Podcast

Subconjunctival Hemorrhage: Free MSRA Podcast

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 🎧 MSRA Deep Dive: Subconjunctival Haemorrhage — The Dramatic but Benign Red EyeA sudden red eye can be alarming, but not all causes are dangerous. This episode unpacks subconjunctival haemorrhage — a classic example of a striking but often harmless presentation. A must-know for MSRA revision and clinical triage.🔍 DefinitionBleeding beneath the conjunctiva, appearing as a painless, bright red patch on the sclera.➡️ Usually unilateral, self-limiting, and benign.💥 Common CausesGrouped for clarity:• Trauma: Rubbing, minor injuries, contact lens use• Valsalva: Coughing, sneezing, straining• Medical: Hypertension, diabetes, bleeding disorders• Medications: Aspirin, NSAIDs, anticoagulants• Spontaneous: ~50% have no known cause• Surgical/Post-op: esp. after intraocular procedures• Neonates: Pressure during delivery🩺 Risk Factors• 👁️ Trauma or eye rubbing• 💊 Anticoagulants or antiplatelets• 📈 Uncontrolled hypertension• 😮‍💨 Valsalva strain• 👶 Vaginal delivery (neonates)• 👁️‍🗨️ Contact lens use🧠 PathophysiologyTiny conjunctival blood vessels rupture → blood collects beneath the clear conjunctiva.💡 “Like red paint under cling film.”🟢 Blood is reabsorbed in 1–3 weeks.🔍 Differential Diagnosis of Red Eye• Conjunctivitis – discharge, gritty sensation• Episcleritis – mild tenderness• Uveitis – pain, photophobia, blurred vision• Keratitis – corneal pain• Acute angle-closure glaucoma – vision loss, halos, headache• Kaposi’s/neoplasms – rare, if mass present❗ Red flag signs (pain, photophobia, vision loss) → urgent referral📊 Epidemiology• Affects ~2.6% of population• Spontaneous cases ~0.6% annually• All age groups affected; common in elderly & neonates🧾 Clinical Features• Sudden, painless red patch over sclera• No discharge, photophobia, or vision change• May change colour as blood reabsorbs (red → yellow-green)• Usually well-demarcated, flat• Visual acuity, pupils, and fundoscopy = normal🔺 Red Flag: No posterior border? → suspect deeper extension, esp. post-trauma🧪 InvestigationsOften not needed. Do if:• On anticoagulants → check INR• Hypertension suspected → check BP• Bilateral/recurrent → clotting screen, FBC• Infants with petechiae → consider non-accidental injury• Trauma → consider CT orbit/head💊 Management• 🟢 Reassure: Self-resolves in 1–3 weeks• Artificial tears if irritation present• Avoid eye rubbing• Continue meds unless clinically indicated otherwise📌 Refer if:• Persistent >3 weeks• Recurrent or bilateral• History of trauma• Suspicion of underlying pathology📈 Prognosis✅ Excellent.• No visual impairment• No lasting complications• Reassurance + simple advice usually all that’s needed🧠 MSRA Tips• Sudden painless red eye + normal vision = subconjunctival haemorrhage• Rule out serious causes if pain, discharge, or visual symptoms present• Always check BP & INR if relevant• Red flags = refer (bilateral, trauma, infants)📚 MSRA Learning Resources📝 Notes: https://www.passthemsra.com/topic/subconjunctival-haemorrhage-revision-notes/🃏 Flashcards: https://www.passthemsra.com/topic/subconjunctival-haemorrhage-flashcards/📖 Q&A Notes: https://www.passthemsra.com/topic/subconjunctival-haemorrhage-accordion-qa-notes/🎯 Rapid Quiz: https://www.passthemsra.com/topic/subconjunctival-haemorrhage-rapid-quiz/🧠 Quiz: https://www.passthemsra.com/quizzes/subconjunctival-haemorrhage/🌐 Main Sites: https://www.passthemsra.com | https://www.freemsra.com🏁 Final ThoughtIt may look scary — but subconjunctival haemorrhage is usually benign and self-resolving. The key is recognising when it’s simple… and when it’s not.#MSRA #RedEye #SubconjunctivalHaemorrhage #Ophthalmology #PasstheMSRA #FreeMSRA #MSRAQuiz #MSRAFlashcards #MSRARevision #BenignRedEye #MedicalEducation

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