Can Telemedicine Treat Subconjunctival Hemorrhage in Children?

Audience: pediatric

A subconjunctival hemorrhage is a common eye condition where a small blood vessel breaks just under the clear surface of the eye, causing a bright red patch. In children, it often looks alarming but usually isn’t painful or harmful and tends to heal on its own within one to two weeks. Telemedicine can be a helpful way to check this condition remotely, especially if the child has no other symptoms. During a tele-visit, a healthcare provider can review pictures or video of the eye and ask questions about symptoms and recent activities. However, if there are additional concerns like pain, vision changes, or repeated bleeding, an in-person exam may be needed. Telemedicine can guide families on care steps and when to seek urgent help, but it cannot replace a full eye exam if complications are suspected. This article explains how telemedicine fits in managing subconjunctival hemorrhage in children, what signs require prompt attention, and how to prepare for and follow up after a telehealth visit.

Red flags — go in person / ER

• Child experiences eye pain or discomfort that worsens.
• Vision changes such as blurriness, double vision, or loss of sight occur.
• Repeated or large subconjunctival hemorrhages or bleeding in both eyes.
• Presence of blood or bruising elsewhere on the body without clear cause.
• Child has a known bleeding disorder or is taking blood-thinning medications.

What telemedicine can do

• Initial assessment of visible red patch on the eye via photos or video.
• Review of symptoms and medical history related to the eye condition.
• Providing advice on home care and monitoring.
• Determining if urgent in-person evaluation is needed.

What telemedicine cannot do

• Performing detailed eye examinations including measuring eye pressure.
• Diagnosing underlying causes requiring specialized tests.
• Managing complications such as vision loss or severe pain.
• Treating conditions that mimic subconjunctival hemorrhage requiring in-person care.

What Is a Subconjunctival Hemorrhage?

A subconjunctival hemorrhage happens when a tiny blood vessel breaks under the clear layer covering the white part of the eye. This causes a bright red or dark patch on the white of the eye. It usually looks worse than it feels because it rarely causes pain or vision problems. In children, it can happen from minor bumps, rubbing the eye, coughing, or even straining during bowel movements.

How Can Telemedicine Help?

Telemedicine allows a healthcare provider to look at the child's eye through photos or video and ask about symptoms and recent events that might have caused the bleeding. This can help decide if the condition is simple and safe to watch at home or if the child needs to see a doctor in person. Telehealth can also provide advice on how to care for the eye and what signs to watch for that need urgent care.

When Is In-Person Care Needed?

If the child has pain, changes in vision, repeated bleeding, blood in both eyes, or if the red patch covers a large part of the eye, an in-person exam is important. Also, if the child has a history of bleeding disorders or is on blood-thinning medicines, a direct evaluation is necessary. Telemedicine cannot perform detailed eye exams or tests that might be needed in these cases.

Caring for a Subconjunctival Hemorrhage at Home

Most subconjunctival hemorrhages heal without treatment. Keeping the child comfortable is key. Avoid rubbing the eye, and use cool compresses if there is any mild irritation. Over-the-counter pain relief may be used if the child feels discomfort, but avoid aspirin unless directed by a healthcare provider. The red patch will fade over days to weeks as the blood is absorbed naturally.

Preparing for a Telemedicine Visit

Before the tele-visit, gather clear photos of the child's eye from different angles and in good lighting. Note any symptoms like pain, vision changes, or recent injuries. Have a list of any medicines the child is taking and any past medical history related to bleeding or eye problems. Being ready helps the healthcare provider make the best assessment remotely.

After the Telemedicine Visit

Follow the care advice given by the healthcare provider. Watch the child’s eye for any new symptoms or worsening signs. If instructed, schedule an in-person visit or emergency care promptly. Keep track of how the redness changes and report back if it does not improve or gets worse over time.

How to prepare for your tele-visit

• Take clear, well-lit photos of the child's affected eye from multiple angles.
• Note any symptoms such as pain, vision changes, or recent eye injuries.
• List all medications the child is currently taking.
• Prepare information about the child's medical history, especially bleeding disorders.
• Ensure a quiet space with good internet connection for the tele-visit.
• Have a family member or caregiver available to assist during the visit if needed.

After your tele-visit

• Follow the healthcare provider’s instructions for home care.
• Avoid rubbing or pressing on the child’s eye.
• Use cool compresses if mild irritation is present.
• Monitor the eye daily for changes in redness, swelling, or new symptoms.
• Seek immediate in-person care if red flags develop.
• Schedule follow-up appointments as recommended.

FAQs

What causes a subconjunctival hemorrhage in children?

It often happens after minor injuries like rubbing the eye too hard, coughing, sneezing, or straining. Sometimes it occurs without any clear cause and is usually harmless.

Is a subconjunctival hemorrhage painful?

Most of the time, it is not painful. Children usually do not feel discomfort, though the eye may look red and alarming.

How long does it take to heal?

The red patch usually fades within one to two weeks as the blood is absorbed naturally by the body.

Can a subconjunctival hemorrhage affect my child's vision?

Typically, it does not affect vision. If your child experiences any vision changes, seek medical care promptly.

When should I seek emergency care?

If your child has eye pain, vision loss, repeated bleeding, or if bleeding occurs in both eyes, seek urgent medical attention immediately.

Sources

1. Subconjunctival hemorrhage — MedlinePlus, U.S. National Library of Medicine.
2. Eye Injuries and Conditions — Mayo Clinic.
3. Conjunctival Hemorrhage — Merck Manuals Consumer Version.
4. Telehealth: Delivering Care Safely During COVID-19 — Centers for Disease Control and Prevention (CDC).

This information is for educational purposes only and is not a substitute for professional medical care. Telemedicine can help assess some conditions but cannot replace a full in-person examination when needed. Always seek immediate care if your child has severe symptoms or red flags.