Snapshot A 25-year-old man presents to his primary care physician for "red eyes." He noticed this symptom in the morning while washing his face. He says that prior to going to sleep he believes both of his eyes were fine and denies any trauma to the eyes. Of note, he was recently prescribed contact lenses, which he began wearing a few days prior to presentation. He denies any pain or itchiness in the eyes and feels otherwise fine. He has no past medical history and only takes a multivitamin, for which he has been taking for many years. On physical exam, there is a subconjunctival hemorrhage, as shown . He is told that these findings should resolve in a few weeks and to return to clinic if the bleeding recurs. Introduction Overview injury to the eye leading to hemorrhage beneath the conjunctiva Epidemiology Incidence idiopathic is the most common cause Risk factors hypertension eye trauma coagulopathy elevated venous pressures (e.g., coughing and Valsalva maneuvers) diabetes mellitus ETIOLOGY Pathophysiology rupture of vessels within the subconjuctiva Anatomy Conjunctiva transparent tissue that adheres to the anterior portion of the sclera and lines the eyelids divided into 2 sections bulbar conjunctiva covers the sclera tarsal conjunctiva covers the inner eyelids Presentation Symptoms painless bright red patch on sclera Studies Coagulation studies indication in patients on anticoagulants and in cases of recurrent subconjunctival hemorrhage and in patients with other signs of unexplained bleeding Differential Conjunctival injection differentiating factors diffusely in the sclera with the examiner being able to discern the vessels Treatment Conservative observation indication initial management Complications Typically a full recovery Prognosis Clears within 1-2 weeks