A subconjunctival bleeding initially appears bright-red underneath the transparent conjunctiva. Later, the bleeding may spread and become green or yellow as the hemoglobin is metabolized. It usually disappears within 2 weeks. Causes
Mechanical
Increased venous pressure (e.g. extreme g-force, straining, vomiting, choking, coughing or strangling) or from straining due to constipation
External pressure changes:Atmospheric pressure changes due to aircraft altitude changes. Mask squeeze from diving without equalizing mask pressure during descent or from diving deeply in water
Eye injury
Head injury
Laser eye surgery or other eye surgery
Zygoma fracture (results in lateral subconjunctival bleeding)
Medical conditions that cause increased venous pressure:
Whooping cough or other extreme sneezing or coughing
Severe hypertension
Medical conditions that affect blood or blood vessels:
Certain infections of the outside of the eye (conjunctivitis) where a virus or a bacterium weaken the walls of small blood vessels under the conjunctiva
Coagulation disorder (congenital or acquired) including Ebola
Acute hemorrhagic conjunctivitis (caused by Enterovirus 70 or Coxsackie A virus)
LeptospirosisSubconjunctival bleeding in infants may be associated with scurvy (a vitamin C deficiency),abuse or traumatic asphyxia syndrome. Diagnosis
Diagnosis is by visual inspection, by noting the typical finding of bright red discoloration confined to the white portion (sclera) of the eye. Management
A subconjunctival bleeding is typically a self-limiting condition that requires no treatment unless there is evidence of an eye infection or there has been significant eye trauma. Artificial tears may be applied four to six times a day if the eye feels dry or scratchy. The elective use of aspirin is typically discouraged. References


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Dyssomnias are a broad classification of sleeping disorders involving difficulty getting to sleep, remaining asleep, or of excessive sleepiness. Dyssomnias are primary disorders of initiating or maintaining sleep or of excessive sleepiness and are characterized by a disturbance in the amount, quality, or timing of sleep. Patients may complain of difficulty getting to sleep or staying asleep, intermittent wakefulness during the night, early morning awakening, or combinations of any of these. Transient episodes are usually of little significance. Stress, caffeine, physical discomfort, daytime napping, and early bedtimes are common factors. Types
There are over 31 recognized kinds of dyssomnias. The major three groups, along with the group types, include:: 15 Intrinsic sleep disorders: 15 
idiopathic hypersomnia,
narcolepsy,
periodic limb movement disorder,
restless legs syndrome,
obstructive sleep apnea,
central sleep apnea syndrome,
sleep state misperception,
psychophysiologic insomnia,
recurrent hypersomnia,
post-traumatic hypersomnia,
central alveolar hypoventilation syndrome,
Extrinsic sleep disorders – 13 disorders recognized, including: 16 alcohol-dependent sleep disorder,
food allergy insomnia,
inadequate sleep routine. Circadian rhythm sleep disorders, both intrinsic and extrinsic – 6 disorders recognized, including: 16 advanced sleep phase syndrome,
delayed sleep phase syndrome,
jetlag,
shift work sleep disorder. See also
Parasomnia
Sleep problems in women
Somnolence

References


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