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Prescribe atropine drops
3%
1/35
Refer to an ophthalmologist
20%
7/35
Treat constipation, no treatment for eye condition is necessary
71%
25/35
Prescribe antibiotic drops
0%
0/35
Patch the eye to prevent further damage
Select Answer to see Preferred Response
This patient presents with a subconjunctival hemorrhage following straining. The condition is benign and does not require further workup or treatment. Subconjunctival hemorrhage is due to rupturing of the fragile subconjunctival vessels leading to a painless hemorrhage. Subconjunctival hemorrhage is a benign process and has many causes, including eye trauma, straining from coughing, vomiting, or constipation, coagulation disorders, and hypertension. Patients are often unaware of the inciting cause. There is no need for treatment, and it typically resolves in weeks. Cronau et al. describe the causes and treatment of red eye, including subconjunctival hemorrhage. While conjunctivitis is the most common cause of red eye, physicians should be aware of other causes, including subconjunctival hemorrhage, corneal abrasions, foreign body, blepharitis, glaucoma, and chemical burns. They state that while no treatment is needed for subconjunctival hemorrhage, warm compresses and lubricants may be used for symptomatic relief. Furthermore, subconjunctival hemorrhage is painless, and thus the presence of pain should prompt further workup in order to identify the cause. Pokhrel et al. describe the recognition and treatment of ocular emergencies. Common ocular emergencies include penetrating injuries, central retinal artery occlusion, retinal detachment, acute angle-closure glaucoma, and chemical burns. They state that all ocular emergencies should be seen by either the emergency department or an ophthalmologist. Of note, treatment of chemical burns should be immediate and not delayed by the evaluation of visual acuity. Figure A reveals a subconjunctival hemorrhage. Illustration A demonstrates a patient with allergic conjunctivitis. These patients often present with eye irritation, itching, watering, and lid swelling. Illustration B shows an irritated, purulent eye due to bacterial conjunctivitis. Illustration C reveals a patient with viral conjunctivitis with hemorrhage. Viral conjunctivitis presents with itching and watering of the eyes and often spreads from one eye to the other. Incorrect answers: Answers 1, 2, 4, and 5: Subconjunctival hemorrhage is a benign process and does not require any further workup or treatment.
3.6
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