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Watchful waiting
88%
38/43
Topical antihistamine
5%
2/43
Topical acyclovir
0%
0/43
Repeated washing of eyelid with soap and water
Topical acetazolamide
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This patient has a subconjunctival hemorrhage. This is a self-limited condition that typically resolves within 2 weeks. Subconjunctival hemorrhage is caused by the rupture of conjunctival or episcleral blood vessels into the subconjunctival space. Bleeding is typically painless, and exam reveals a sharply demarcated area of bleeding on the sclera. Recent surgery, trauma, drainage, and significant pain are warning signs that warrant a broader differential diagnosis. Cronau et al. discuss the diagnosis and management of the patient with a red eye. They note that common causes include conjunctivitis, blepharitis, corneal abrasion, foreign body, subconjunctival hemorrhage, keratitis, iritis, glaucoma, chemical burn, and scleritis. Sahinoglu-Keskek et al. present a retrospective observational study of 50 patients with subconjunctival hemorrhage. They note that the most commonly associated condition in spontaneous hemorrhage was hypertension, and that spontaneous hemorrhage appeared equally often in the temporal and nasal portions of the eye. Figure A shows a patient with subconjunctival hemorrhage. Incorrect Answers: Answer 2: Topical antihistamine drops would be appropriate for allergic conjunctivitis. Answer 3: Topical acyclovir drops are used to treat herpes conjunctivitis. Answer 4: Washing with soap and water can help blepharitis. Answer 5: Topical acetazolamide is a treatment for acute closed-angle glaucoma.
4.7
(3)
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