Ver el código de «Hemorrhagic chemosis»

==Background==
*Not to be confused with standard [[subconjunctival hemorrhage]]
*Sometimes referred to as subconjunctival hematoma or bloody chemosis
*Results from the rupture of subconjunctival blood vessels, typically due to significant trauma

==Clinical Features==
[[File:PMC4005189 MEAJO-21-196-g002.png|thumb|Marked lid edema and subconjunctival hemorrhagic chemosis, with "black ball [[hyphema]]" in the right eye after direct trauma.]]
*Normally associated with significant ocular trauma.
*Painful (at rest or with eye movements)
*May have change in visual acuity
*Examination
**Fresh raised hemorrhagic chemosis

==Differential Diagnosis==
The following are conditions that may appear similarly to hemorrhagic chemosis but have an alternate etiology:
*Carotid-cavernous fistula
*Cavernous venous thrombosis (can present with chemosis + proptosis)

{{Unilateral red eye DDX}}

==Evaluation==
===Workup===
*Check visual acuity
*Visualize injury with slit lamp exam
*Consult ophthalmology if available or consider transfer if not
*Obtain orbital CT imaging
*Once globe rupture is ruled out, continue with tonometry and fluoroscein exam.
*Consider
**Coagulation studies
**Vessel imaging of the head if suspicion for CVT

===Diagnosis===
While most cases of hemorrhagic chemosis occur following trauma, it is important to also consider whether the patient has an underlying coagulopathy or structural condition (ie. cavernous venous thrombosis) that would predispose them to this or a similarly appearing condition<ref>Pargament J, Corrêa ZM, Augsburger JJ. Ophthalmic trauma. In: Riordan-Eva P, Augsburger JJ, eds. Vaughan and Asbury’s General Ophthalmology. 19 ed. New York, NY: McGraw-Hill; 2018:380-389.</ref>.
When assessing a patient with hemorrhagic chemosis, the following associated conditions should be considered:
*Globe rupture
*Scleral laceration
*Penetrating foreign body

==Management==
If [[globe rupture]] is suspected:
*Consult ophthalmology if haven't already or transfer patient as this is an ophthalmologic emergency
*Initiate broad spectrum [[antibiotics]]
*Check [[tenatus vaccine]] status and administer if due
*Consider placement eye shield as protective measure to avoid further damage

==Disposition==
*Ultimate disposition often depends on the associated ocular trauma for which hemorrhagic chemosis may be a sign.

==See Also==
*[[Subconjunctival hemorrhage]]

==External Links==


==References==
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[[Category:Ophthalmology]]