Management of subconjunctival haematoma by tissue plasminogen activator.

A patient with subconjunctival haematoma related to enterovirus 70 who was treated with tissue plasminogen activator (tPA) is reported. A 46-year-old man developed a severe subconjunctival haematoma and discharge in the left eye. Investigations, including coagulation tests, showed no abnormalities apart from a high-serum antibody titre for enterovirus 70. The polymerase chain reaction demonstrated enterovirus 70 DNA in resected conjunctival tissue, leading to a diagnosis of acute haemorrhagic conjunctivitis. The left eye was treated with a single subconjunctival injection of tPA (16 000 IU) and the subconjunctival haematoma resolved completely after 3 days. Severe subconjunctival haematoma can occur in patients with acute haemorrhagic conjunctivitis due to enterovirus 70. Subconjunctival injection of tPA may be useful for the treatment of severe subconjunctival haematoma.