Which of the following ocular side effects would you MOST expect if a patient is taking Warfarin?

• A. CRVO
• B. Subconjunctival hemorrhage
• C. Drusen
• D. CNVM

Answer: (B)

Warfarin’s anticoagulant effect increases the tendency to bleed, so the ocular side effect you’d most expect is a subconjunctival hemorrhage. This looks like a bright red patch on the sclera and occurs when tiny conjunctival vessels rupture. It’s usually painless, harmless, and resolves on its own in about one to two weeks as the blood is reabsorbed. Other options describe conditions not driven by bleeding tendency from anticoagulation—drusen and CNVM are degenerative changes related to age-related macular degeneration, and central retinal vein occlusion is a vascular blockage due to risk factors like hypertension or atherosclerosis rather than a direct anticoagulant effect.