Infant Subconjunctival Hemorrhage

If your newborn has red spots on the whites of the eyes, he or she may have a subconjunctival hemorrhage.

 A subconjunctival hemorrhage is a medical condition that happens when the small blood vessels located just beneath the eye rupture. When a blood vessel ruptures, blood pools beneath the sclera (the clear membrane that covers the eye). The result is a bright red spot on the white of the eye. 

what is subconjunctival hemorrhage

Although a subconjunctival hemorrhage can happen at any age, it typically happens to newborn infants when trauma occurs during a stressful delivery.

What Causes Infant Subconjunctival Hemorrhage?

A subconjunctival hemorrhage may occur during a long, difficult labor when too much pressure is placed on the infant during contractions. As the infant moves through the birth canal, the head is under constantly changing pressure, which can be forceful during the delivery. This can cause the blood vessels in the eyes to rupture. This is most common in infants who are large for their gestational age, or who are having a hard time making their way down the birth canal. 

In addition, subconjunctival hemorrhages can be caused by doctors applying inappropriate pressure and force on the infant during the labor and delivery. This is more common when birth-assisting tools are used, such as forceps or a vacuum-extraction tool. If your infant also has swelling on the head, he or she may also have a newborn hematoma under the skin. This condition is called cephalohematoma.

Infant Subconjunctival Hemorrhage Symptoms

The most common symptoms of subconjunctival hemorrhage is a bright red or dark red patch in the white areas of the infant’s affected eye. After a traumatic delivery, the eye usually shows redness right away or within a few hours. Sometimes the redness will cover the entire white of the affected eye. It also may increase in severity over the next 24 hours after birth before tapering off.

Diagnosis of Infant Subconjunctival Hemorrhage

In most instances, a doctor can diagnose subconjunctival hemorrhage by simply looking at the infant’s affected eye. Usually no additional tests are required. However, in some instances, the baby’s blood pressure may be taken and monitored.

Infant Subconjunctival Hemorrhage Treatment

There isn’t usually a treatment for subconjunctival hemorrhage as it usually clears up on its own within a few weeks or so. Subconjunctival hemorrhage treatment at home may include artificial tears, which can help with itchiness and pain. Medications are generally not necessary. The best thing you can do is monitor how the eye is healing and contact your doctor if it looks like it is getting worse or is not improving. 

In some cases, a subconjunctival hemorrhage may lead to permanent eye damage, although this is extremely rare. In other instances, a subconjunctival hemorrhage may be a sign of other, more serious birth injuries. Since a subconjunctival hemorrhage can be caused by trauma during labor and delivery, in many cases, the infant experiences other types of trauma as well.  For example, facial paralysis is commonly caused by forceps during delivery..

Prognosis for Infants with a Subconjunctival Hemorrhage

A subconjunctival hemorrhage should clear up on its own within a few weeks. However, if you don’t see any improvement during this time period, it’s important to contact your doctor immediately.

Don’t be alarmed if your baby’s eyes turn yellow before clearing up. This is a normal part of the healing process as the blood is absorbed.

Tiffany Lee, M.D.

Page Medically Reviewed By Tiffany Lee, M.D.

Tiffany Lee, M.D. is a board certified general pediatrician. She has experience in primary and urgent care. She is also a skilled tele-health practitioner. She is a regular medical reviewer for Birth Injury Guide.

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