Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways

Purpose: To demonstrate the role of ocular lymphatic involvement in aiding the drainage and resolution of subconjunctival hemorrhage. Methods: We present the case of a 63-year-old Caucasian female who developed a subconjunctival hemorrhage following the administration of a subconjunctival anesthetic...

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Main Authors: Ashton Zheng-Boon Lau, Grace YF. Tang, William H. Morgan, Geoffrey ZP. Chan
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:American Journal of Ophthalmology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2451993625001215
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author Ashton Zheng-Boon Lau
Grace YF. Tang
William H. Morgan
Geoffrey ZP. Chan
author_facet Ashton Zheng-Boon Lau
Grace YF. Tang
William H. Morgan
Geoffrey ZP. Chan
author_sort Ashton Zheng-Boon Lau
collection DOAJ
description Purpose: To demonstrate the role of ocular lymphatic involvement in aiding the drainage and resolution of subconjunctival hemorrhage. Methods: We present the case of a 63-year-old Caucasian female who developed a subconjunctival hemorrhage following the administration of a subconjunctival anesthetic during cataract surgery. Intraoperative optical coherence tomography was utilized to image these structures within the deep and middle conjunctival-Tenon's space. Results: Subconjunctival hemorrhage was visualized and saccular blood-filled structures developed adjacent to sites of hemorrhage. Intraoperative optical coherence tomography confirmed the presence of blood within structures containing partitions reminiscent of valvular leaflets, indicating their lymphatic origin. Rapid resolution of the subconjunctival hemorrhage was noted during the immediate postoperative period. Conclusion: Subconjunctival hemorrhage may have its resolution assisted by conjunctival lymphatic vessels. Our findings confirm that lymphatic structures may play an under-appreciated role in assisting the clearance of macromolecules from the subconjunctival space.
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series American Journal of Ophthalmology Case Reports
spelling doaj-art-3c12241a80474b7d882b4e7cc8d70bd92025-08-20T03:50:06ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362025-09-013910236810.1016/j.ajoc.2025.102368Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathwaysAshton Zheng-Boon Lau0Grace YF. Tang1William H. Morgan2Geoffrey ZP. Chan3Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, AustraliaCentre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia; Department of Ophthalmology, Fremantle and Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, AustraliaCentre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia; Lions Eye Institute, Perth, Western Australia, AustraliaCentre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia; Lions Eye Institute, Perth, Western Australia, Australia; Department of Ophthalmology, Fremantle and Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia; Corresponding author. Lions Eye Institute, 2 Verdun Street, Nedlands, Perth, Western Australia 6009, Australia.Purpose: To demonstrate the role of ocular lymphatic involvement in aiding the drainage and resolution of subconjunctival hemorrhage. Methods: We present the case of a 63-year-old Caucasian female who developed a subconjunctival hemorrhage following the administration of a subconjunctival anesthetic during cataract surgery. Intraoperative optical coherence tomography was utilized to image these structures within the deep and middle conjunctival-Tenon's space. Results: Subconjunctival hemorrhage was visualized and saccular blood-filled structures developed adjacent to sites of hemorrhage. Intraoperative optical coherence tomography confirmed the presence of blood within structures containing partitions reminiscent of valvular leaflets, indicating their lymphatic origin. Rapid resolution of the subconjunctival hemorrhage was noted during the immediate postoperative period. Conclusion: Subconjunctival hemorrhage may have its resolution assisted by conjunctival lymphatic vessels. Our findings confirm that lymphatic structures may play an under-appreciated role in assisting the clearance of macromolecules from the subconjunctival space.http://www.sciencedirect.com/science/article/pii/S2451993625001215LymphaticsConjunctivaAqueous humorSubconjunctival hemorrhageBleb-forming surgery
spellingShingle Ashton Zheng-Boon Lau
Grace YF. Tang
William H. Morgan
Geoffrey ZP. Chan
Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways
American Journal of Ophthalmology Case Reports
Lymphatics
Conjunctiva
Aqueous humor
Subconjunctival hemorrhage
Bleb-forming surgery
title Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways
title_full Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways
title_fullStr Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways
title_full_unstemmed Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways
title_short Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways
title_sort drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways
topic Lymphatics
Conjunctiva
Aqueous humor
Subconjunctival hemorrhage
Bleb-forming surgery
url http://www.sciencedirect.com/science/article/pii/S2451993625001215
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AT williamhmorgan drainageofsubconjunctivalhemorrhagethroughconjunctivallymphaticpathways
AT geoffreyzpchan drainageofsubconjunctivalhemorrhagethroughconjunctivallymphaticpathways