Subconjunctival Hemorrhage With Shiner

The mother of this 10-year-old boy noticed the shiner on her son's right eye after he awakened one morning. The child had bronchitis and a persistent cough for the past few days. Particularly alarmed by the extensive subconjunctival hemorrhage that appeared the next morning, the parent brought her child for medical evaluation. The youngster had no history of injury.

Robert P. Blereau, MD of Morgan City, La, comments that increased pressure to the vessels of the eye produced by coughing, sneezing, and forceful vomiting can rupture subconjunctival vessels and produce hemorrhage. A shiner also may arise from gravity drainage of the subconjunctival bleeding. The shiner, however, is somewhat unusual in this setting. Dr Blereau reassured both the patient and his anxious mother, telling them that the asymptomatic condition would clear spontaneously within 4 to 6 weeks, and no treatment was required.