A newborn subconjunctival hemorrhage (NSCH) can appear alarming to new parents, but it is almost always harmless. This condition involves a tiny blood vessel rupturing just beneath the clear surface of the eye. The resulting red patch is essentially a small bruise on the eye’s white surface. NSCH is a frequent finding after birth, typically causes no pain, and resolves on its own without specific treatment.
What Newborn Subconjunctival Hemorrhage Looks Like
The most noticeable sign of this condition is a distinct red spot or patch covering a portion of the sclera, the white part of the eye. This patch may be bright scarlet or a deeper, darker red, depending on the severity of the bleed. The hemorrhage appears flat and is contained beneath the conjunctiva, the thin, transparent membrane covering the sclera. The shape of the redness is often irregular, sometimes looking like a splotch or a crescent, and it does not cover or affect the pupil or the iris.
The condition is painless and does not affect the baby’s ability to see. Because the blood is trapped under the surface, it cannot be wiped away or rinsed out. The spot may sometimes increase slightly in size in the first 24 to 48 hours before the healing process begins.
Why This Happens During Delivery
The primary cause of NSCH is the physical stress and intense pressure changes that occur during the birthing process. As the baby moves through the narrow birth canal, the head and body experience significant squeezing and compression. This intense compression, particularly of the chest and abdomen, leads to a sudden and temporary spike in the baby’s venous pressure.
This abrupt pressure surge causes the tiny, delicate blood vessels on the surface of the eye to rupture. NSCH can still occur even if a baby is delivered by cesarean section, especially if the mother experienced strong contractions or significant pushing beforehand. Prolonged labor or the use of assistive tools like forceps or a vacuum extractor also increase the likelihood of this vessel rupture.
What Parents Need to Know About Safety and Healing
A diagnosis of NSCH means the condition is benign and does not require intervention, such as eye drops or medication. The body naturally handles the healing process, similar to how a bruise fades on the skin. The trapped blood is slowly reabsorbed by the body’s tissues.
The resolution typically takes between 10 days and three weeks, though larger hemorrhages may take slightly longer. As the blood is broken down and absorbed, the red patch may change color, often becoming a yellowish hue before disappearing completely. This change confirms the injury is healing effectively, and parents should simply monitor the eye as the spot fades.
While NSCH is almost always a mild condition, parents should watch for specific signs that warrant a call to the pediatrician. These symptoms are not typical for a simple subconjunctival hemorrhage and may indicate a different underlying issue:
- Signs of pain, such as excessive crying or light sensitivity.
- Pus or thick discharge from the eye.
- The hemorrhage getting noticeably worse after the first few days.
- Bleeding present elsewhere in the eye, such as in the iris or pupil.