Bilateral subconjunctival haemorrhage in spinal cord injury: a case report

A patient with a spinal cord injury and neurogenic bladder experienced bilateral subconjunctival hemorrhages (bleeding in the eyes) after being treated with anticoagulants and attempting to urinate by increasing abdominal pressure. The patient had been hospitalized for a spinal fracture and was on anticoagulation therapy to prevent blood clots. After removing a urinary catheter, the patient used abdominal pressure to urinate, which may have contributed to the eye bleeding. Re-insertion of the urinary catheter led to improvement in the eye bleeding. The doctors suggest carefully assessing bleeding risks in spinal cord injury patients with neurogenic bladder who are on anticoagulants and attempt urination using abdominal pressure.

• 1
  The patient developed subconjunctival hemorrhages in both eyes after urinary catheter removal and increased abdominal pressure to urinate while on anticoagulation therapy.
• 2
  Re-indwelling the urinary catheter led to improvement in the subconjunctival hemorrhages, suggesting a correlation between increased abdominal pressure during urination and the bleeding.
• 3
  The case highlights the potential risk of bleeding in spinal cord injury patients with neurogenic bladder who are on anticoagulants and use abdominal pressure to facilitate urination.