Why do babies have red streaks in the whites of their eyes?

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Bui Thi Ha - Pediatrician - Neonatologist - Department of Pediatrics - Neonatology - Vinmec Ha Long International General Hospital.
Newborn red eyes or blood clots are bleeding from the conjunctiva. It is caused by the rupture of small blood vessels from mechanical trauma during birth or can occur after a baby cries, coughs or vomits repeatedly. However, some cases of conjunctival hemorrhage occur without an obvious cause. Hemorrhagic lesions of the conjunctiva usually clear up on their own within 1 to 3 weeks without treatment and usually do not affect the child's vision. Therefore, parents should not be too worried when detecting red spots or red blood clots in their newborn's eyes.

1. Why are newborn eyes red?

Many parents worry when they find out that their newborn's eyes are red and wonder if this condition is dangerous to the child's vision and health. Red spots or even blood clots appearing in the eyes of infants are characteristic of subconjunctival hemorrhage which is quite common and can occur at any age. In adults, conjunctival hemorrhage usually occurs as a result of excessive coughing. However, anything that causes a sudden change in pressure can rupture a blood vessel and cause bleeding. Therefore, in some cases, subconjunctival hemorrhage may be a sign of hypertension.
Although subconjunctival hemorrhage can occur at any age, it is quite common in neonates, especially in neonates who have experienced trauma during delivery. The intense and variable pressures during labor can cause blood vessels in a newborn's eyes to burst.
The pressure experienced by the newborn comes from uterine contractions during labor and often causes subconjunctival hemorrhage due to the effect of increasing intravascular pressure to its maximum value and rupture blood vessel. Babies born overweight have a higher risk of this type of damage.
Bleeding under the conjunctiva can also occur during labor with the use of an assistive device to help bring the baby out faster when the baby is stuck or the fetus fails in labor. The most commonly used means of assisted delivery are forceps or suction cups.

2. Symptoms of neonatal subconjunctival hemorrhage

Newborn red eyes or red eyes in newborns are the most prominent and often the first signs parents notice. A simple subconjunctival hemorrhage will not cause pain or other complications.
Newborns diagnosed with subconjunctival hemorrhage will be observed under magnifying glass. The image of blood clots located below the conjunctiva, attached to the white membrane of the cornea, is the sole criterion for diagnosis. However, neonatal subconjunctival hemorrhage may be an isolated sign or a symptom of intracranial haemorrhagic injury resulting from the trauma of labor. This is a serious condition that increases the risk of epilepsy and other sequelae from hypoxic brain cell damage.

3. Methods of treatment for bleeding under the conjunctiva of the eye

A simple neonatal subconjunctival hemorrhage usually leaves no sequelae and resolves spontaneously after a few weeks without any intervention. The most important thing for parents to do is to pay attention to the child when the red spots or red lumps in the eyes are healing. During recovery, the infant's eyes may feel itchy and should be treated with eye drops.

Although the disease can heal on its own, parents should also take the child to a medical facility so that the child can monitor the progress of the disease as well as make sure that serious complications such as blood clots are present. Intracranial hematoma did not appear. In rare cases, subconjunctival hemorrhage can lead to irreversible eye damage. The choice of treatment in these cases will depend on the severity of the individual patient.
If an infant shows warning signs of serious complications, parents should see an ophthalmologist as soon as possible. These symptoms include:
Signs of an eye infection such as swelling of the eyelids, redness or discharge of pus Blood in places other than the conjunctiva or the whites of the eye Problems related to the eye vision Moderate to severe eye pain More extensive subconjunctival hemorrhage Fortunately, neonatal subconjunctival hemorrhages are common and usually not life-threatening. Parents always need to closely monitor the progress of the child's disease to detect abnormal symptoms as soon as possible. The average recovery time is 1 to 2 weeks, which varies from baby to baby.
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References: birthinjuryhelpcenter.org, cerebralpalsysymptoms.com