In highly recurrent cases, testing for blood-tissue abnormalities, clotting disorders, hypertension, diabetes and malignancies should be done.
This includes, but is not limited to, a complete blood count with differential and platelets, prothrombin time, activated partial thromboplastin time, fasting blood sugar, blood pressure
evaluation, echocardiogram, lipid profile, homocysteine levels, antiphosolipid antibodies, protein s, protein c, antithrombin III, factor V Leiden, beta-glycoprotein, sickle cell preparation
and human immunodeficiency virus titres.
In most cases, SCH episodes are not so severe that they warrant cessation of a patient’s necessary systemic medications. However, in cases where the occurrence is substantial, communication and discussion with the internist is advised. As a rule SCH is rarely evacuated.
Blood pressures should be examined in patients with subconjunctival hemorrhages, particularly in older patients.
Any 360° subconjunctival hemorrhage following trauma should invoke a suspicion and investigation to rule out ruptured globe.
Recurrent events may suggest a situation of abuse, tumor or excessive anticoagulation therapy
(Requiring an International Normalized Ratio [INR] evaluation to determine the patient’s sensitivity to clotting).
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