Red flags & when to go in person for Subconjunctival Hemorrhage in Children

Audience: pediatric

A subconjunctival hemorrhage happens when a small blood vessel breaks just under the clear surface of the eye, causing a bright red patch. In children, this can look alarming but often is harmless and usually clears up on its own within one to two weeks. It may happen after minor injury, coughing, or straining. While most cases do not need urgent care, some signs mean you should see a healthcare provider in person. These include pain, changes in vision, repeated bleeding, or bleeding after a serious injury. Telemedicine can help assess many cases by reviewing symptoms and eye appearance through video. However, if red flags appear, an in-person visit is important to rule out more serious problems. This guide helps parents and caregivers know when to seek immediate care and how telemedicine fits into managing subconjunctival hemorrhage in children.

Red flags — go in person / ER

• Eye pain or discomfort that does not improve
• Changes in vision such as blurriness or loss of sight
• Repeated or worsening bleeding or redness after initial appearance

What telemedicine can do

• Assessment of mild subconjunctival hemorrhage via video
• Providing advice on symptom monitoring and care
• Determining if urgent in-person care is needed

What telemedicine cannot do

• Performing physical eye examinations requiring specialized equipment
• Managing severe eye pain or vision changes
• Treating infections or injuries needing immediate intervention

What is a Subconjunctival Hemorrhage?

A subconjunctival hemorrhage is bleeding under the clear layer covering the white part of the eye. It looks like a bright red or dark patch on the eye. This happens when tiny blood vessels break. In children, it often happens after coughing hard, sneezing, rubbing the eye, or a minor bump. It usually does not hurt or affect vision and often goes away without treatment in about 1 to 2 weeks.

Common Causes in Children

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If your child has frequent or unexplained bleeding, it's important to talk to a healthcare provider.

When to Seek In-Person Care

Most subconjunctival hemorrhages heal on their own. However, go to a healthcare facility if your child has:

These signs may mean a more serious problem that needs urgent care.

How Telemedicine Can Help

Telemedicine allows healthcare providers to assess your child's eye through video calls. They can ask about symptoms, look at the eye, and decide if in-person care is needed. Telemedicine is useful for:

However, telemedicine cannot perform physical eye exams or treatments that require special equipment.

Preventing Subconjunctival Hemorrhages

To help prevent these eye bleeds in children:

If your child has a bleeding disorder, follow your healthcare provider’s advice carefully.

Typical Care and Recovery

No special treatment is usually needed. The red patch will fade as the blood is absorbed. You can:

If symptoms worsen or do not improve in 2 weeks, see a healthcare provider.

How to prepare for your tele-visit

• Have good lighting to show the child's eye clearly on video
• Prepare to describe when the red patch appeared and any symptoms
• Note any recent injuries, illnesses, or medications
• Be ready to answer questions about the child's medical history
• Have a list of any other symptoms your child is experiencing

After your tele-visit

• Follow provider’s advice on eye care and symptom monitoring
• Use lubricating eye drops if recommended
• Watch for any new or worsening symptoms
• Schedule an in-person visit if red flags develop
• Keep follow-up telemedicine appointments as advised

FAQs

Is a subconjunctival hemorrhage painful for children?

Usually, it is not painful. Most children do not feel discomfort, though some may notice mild irritation or a scratchy feeling.

How long does it take to heal?

It typically takes about 1 to 2 weeks for the red patch to fade completely as the blood is absorbed.

Can subconjunctival hemorrhage affect my child's vision?

No, it usually does not affect vision. If your child has any vision changes, seek medical care promptly.

Should I worry if my child has frequent eye bleeds?

Frequent or unexplained eye bleeding should be evaluated by a healthcare provider to rule out underlying conditions.

Can telemedicine replace all eye exams for this condition?

Telemedicine can help assess mild cases and guide care but cannot replace detailed eye exams needed for serious symptoms or injuries.

Sources

1. Subconjunctival Hemorrhage — MedlinePlus, U.S. National Library of Medicine.
2. Eye Injuries and Conditions in Children — American Academy of Pediatrics.
3. Conjunctival Hemorrhage — Mayo Clinic.
4. Eye Health and Safety — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has any concerning symptoms or red flags, seek immediate evaluation by a healthcare professional.