What is it?
Subconjuctival hemorrhage not caused by direct ocular trauma is usually the result of a sudden increase in intrathoracic pressure, as in sneezing, coughing, or straining to evacuate. Under this stress, the weak-walled conjunctival vessels may burst, especially in the elderly.
Also consider systemic hypertension and blood dyscrasias as causes. In neonates, subconjunctival hemorrhage is a common result of vaginal delivery.
How does it present?
With a blotchy redness usually confined to one area of the conjunctiva. A careful look shows that the redness comes from extravascular blood.
What to do?
No treatment is necessary. If there has been no history of coughing or straining, measure blood pressure and investigate for blood dyscrasia, especially if the hemorrhage is recurrent.