What is the best management for a subconjunctival hemorrhage in a stable patient with no ocular pain or abnormal exam findings?

• A. Observation and reassurance
• B. Topical antibiotic drops
• C. Oral steroids
• D. Urgent ophthalmology referral

Answer: (A)

Subconjunctival hemorrhage happens when a tiny blood vessel on the surface of the eye ruptures, creating a bright red patch on the white of the eye. In a stable patient who has no eye pain and no other abnormal findings, this is usually a benign, self-limited event. The blood is absorbed over days to a couple of weeks, and vision remains unaffected.

Because there are no signs of infection, trauma, or eye disease requiring urgent attention, the best management is simply observation and reassurance. No antibiotics are needed, and there’s no indication for systemic therapy or urgent referral when the exam is normal and the patient is comfortable.

Seek urgent care only if red flags appear, such as new or worsening eye pain, decreased vision, significant trauma, a return of the hemorrhage after it has resolved, or if the patient is on anticoagulants or has a bleeding disorder with recurrent events.