Bilateral Subconjunctival Hemorrhage Following Vaginal Delivery: A Case Report

Background: Subconjunctival hemorrhage is a superficial extravasation of blood beneath the conjunctiva. It is usually painless, self-limiting and benign, although its appearance may cause significant anxiety. Labor-related Valsalva maneuvers may increase venous pressure and precipitate conjunctival vessel rupture. Case presentation: A 38-year-old multiparous woman presented with sudden bilateral ocular redness immediately after an uncomplicated vaginal delivery. Visual acuity was preserved at 20/20 in both eyes, and clinical examination showed extensive bilateral subconjunctival hemorrhage without visible corneal or obvious intraocular involvement. There was no history of trauma, hypertension, diabetes, anticoagulant therapy or hematological disease. Management and conclusion: Conservative management was provided with reassurance, compresses and artificial tears. This case highlights a rare postpartum ocular finding likely related to increased intra-abdominal and venous pressure during the second stage of labor. Red flags and systemic risk factors should be actively excluded.