Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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Blood after significant eye trauma
A subconjunctival-looking bleed after sharp, high-velocity or substantial blunt trauma may coexist with a serious ocular injury rather than a harmless isolated surface haemorrhage.
Action: Arrange emergency eye assessment when the mechanism or examination suggests penetration, globe rupture, reduced vision or significant pain. Avoid pressure on the eye, manipulation and tonometry if an open-globe injury is possible; use a rigid protective shield where available.
Synopsis
Recognise a typical superficial ocular bleed, confirm that reassurance is appropriate, and investigate trauma, recurrence or systemic bleeding features without unnecessarily interrupting essential medication.
An uncomplicated subconjunctival haemorrhage is a sharply demarcated patch of blood under the conjunctiva with normal visual function.
The appearance can be dramatic while the eye remains comfortable; substantial pain or light sensitivity requires another explanation.
Most uncomplicated episodes clear spontaneously within one to two weeks without specific treatment.
Key red flags
Pain, photophobia, persistent visual reduction or an abnormal pupil is inconsistent with a straightforward isolated subconjunctival haemorrhage.
Investigation priorities
01
Visual acuity, pupil and external eye assessmentFirst step
Confirm that the presentation fits a superficial isolated bleed.
Management branches
Typical isolated bleedExplain natural recovery and provide a safety net
The eye is comfortable, vision is normal and assessment identifies no concerning injury or associated findings.
Explain that blood has collected beneath the conjunctiva and commonly clears without treatment over one to two weeks.
Check blood pressure and relevant medicines, and address a clear local irritant or straining trigger when feasible.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.