A subconjunctival hemorrhage is bleeding underneath the conjunctiva (the white part of the eye). This part of the eye has many small, fragile blood vessels that are easily ruptured or broken. When this happens, blood leaks into the space between the mucous membrane that covers the front of the eye (conjunctiva) and the white outer layer of the eyeball (sclera). A bruise will often form that looks black or blue underneath the skin.
A subconjunctival hemorrhage initially appears bright red underneath the transparent conjunctiva. Later, the hemorrhage may spread and become green or yellow, like a bruise. Subconjunctival hemorrhages are common and self-resolving. Usually, any bruising disappears within 2 weeks to a month. Subconjunctival hemorrhages do not threaten the vision.
When our birth injury lawyers look at medical malpractice cases involving a subconjunctival hemorrhage, it is very unlikely that the eye bleed is the focus of the case. Instead, the hemorrhage is a marker for other more serious birth injuries.What Causes a Subconjunctival Hemorrhage?
The most common cause of subconjunctival hemorrhages is an increase in pressure in the vessels of the eye. Usually, this pressure is the result of lifting, sneezing, coughing, or other Valsalva maneuvers. Subconjunctival hemorrhages can also happen from the pressure of contractions during prolonged, stressful vaginal deliveries.
A subconjunctival hemorrhage can also be caused by doctors when they employ excessive force in attempted to assist the delivery. This is particularly true when obstetrical devices such as forceps and vacuum extractors are utilized. Negligent use of these birth assistance tools frequently causes external physical trauma and is a common cause of conditions such as subconjunctival hemorrhage.Diagnosis of Subconjunctival Hemorrhage
Diagnosing a subconjunctival hemorrhage is often done just from visual observation of the eye by the doctor. Additional testing is not typically necessary, however, the baby's blood pressure may be taken and monitored as a precaution.Subconjunctival Hemorrhages May be a Symptom of More Serious Trauma
Although a subconjunctival hemorrhage is not a various serious injury by itself, it is an indication that the baby's skull was subject to significant pressures during childbirth. Sometimes a subconjunctival hemorrhage may just be the most visible symptom of intracranial pressures during childbirth. These intracranial pressures can be the source of more traumatic birth injuries such as cerebral palsy. Subconjunctival hemorrhages often warrant further observation and testing to evaluate whether a baby has additional injuries. If doctors used forceps or other birth assistance tools during the delivery, a subconjunctival hemorrhage should be a cause for concern and may warrant further examination.How Are Subconjunctival Hemorrhages Treated?
In most cases, a subconjunctival hemorrhage does not require any treatment at all. The hemorrhage will typically clear up and heal on its own within a few weeks. Artificial tear solutions are sometimes recommended to alleviate discomfort. In very rare cases a subconjunctival hemorrhage can lead to more serious eye damage so it's important for a doctor to monitor the condition as it heals.Settlements & Verdicts
Below are summaries of reported settlements and verdicts in cases in which subconjunctival hemorrhage was involved in connection with other, more serious birth injuries. The number of verdicts and settlements is limited simply because subconjunctival hemorrhage is normally just the starting point of more serious birth injuries that end up getting discussed in the case.
- Morales v. Bronx-Lebanon Hosp. (New York 2014) $156,800: In this case, the baby's subconjunctival hemorrhages and facial bruising turned out to be indications of more significant neurological birth injuries. Plaintiff's birth injury lawyer alleged that doctors and hospital were negligent in their management and handling of stressful labor and delivery. The alleged long-term injuries were limited and the claims settled for $156,820. Given the amount settlement, you can assume either the injuries were not significant or the plaintiff's attorneys believed they would have had an impossible time proving the case at trial.
- Jenkins v. Botsford General Hosp. (Michigan 2013) $125,000: Baby was born with a host of physical injuries including subconjunctival hemorrhages and facial contusions which were allegedly evidence of trauma that ultimately caused a brachial plexus injury. The hospital was accused of failing to provide adequately trained staff and the doctor was accused of using excessive force with lateral traction in his efforts to facilitate delivery. So again, you see an example of the hemorrhage being a marker for a more significant injury. The defendants contested liability but agreed to settle the case for $125,000.
Birth-related injuries such as subconjunctival hemorrhages can often be the first indication of more serious physical and neurologic injuries to a baby. If you experienced a difficult or traumatic delivery and think your baby may have suffered a birth injury as a result, contact the birth injury lawyers at Miller & Zois for help. We can fully investigate your case at no charge and let you know whether medical malpractice occurred. Call us at 800-553-8082 today or get a free online consultation.