Bleeding in the Eye: Understanding Subconjunctival Hemorrhages

Photo by Andrea Piacquadio

When it comes to eye health, there are various conditions that can affect the delicate structures of the eye. One such condition is a subconjunctival hemorrhage, which can be alarming due to its sudden appearance.

What is a Subconjunctival Hemorrhage?

A subconjunctival hemorrhage is a relatively common eye condition characterized by the appearance of bright red patches on the white part of the eye (sclera). These patches occur when blood vessels in the conjunctiva, the clear layer covering the sclera, break and blood leaks into the surrounding tissue.

Causes of Subconjunctival Hemorrhage

Several factors can contribute to the development of subconjunctival hemorrhage, including:

• Trauma: Injury to the eye, such as from rubbing, poking, or being hit in the eye, can cause blood vessels to rupture.
• Strain: Straining during activities such as heavy lifting, coughing, sneezing, or vomiting can increase pressure in the blood vessels, leading to rupture.
• Medical Conditions: Certain medical conditions, such as hypertension (high blood pressure), diabetes, blood clotting disorders, and eye infections, can increase the risk of subconjunctival hemorrhage.
• Medications: Blood-thinning medications like aspirin or anticoagulants may increase the likelihood of bleeding in the eye.

Photo by Victor Freitas

Symptoms

The most noticeable symptom of subconjunctival hemorrhage is the presence of a bright red patch on the white of the eye. However, this condition is typically painless and does not affect vision. In some cases, a person may experience a slight scratchy sensation on the surface of the eye.

Diagnosis

Subconjunctival hemorrhage is usually diagnosed through a comprehensive eye examination. Your eye care professional will examine your eye using a slit lamp microscope to assess the extent of the hemorrhage and to rule out any underlying conditions.

Treatment

In most cases, subconjunctival hemorrhage resolves on its own without the need for medical intervention. The blood will gradually be absorbed by the surrounding tissue, much like a bruise, and the redness will fade over the course of a few days or weeks.

• Sunglasses: If you are worried about the appearance of your eyes, wearing sunglasses can help hide the redness.
• Avoid Irritants: To prevent further irritation, avoid rubbing or touching your eyes.
• Artificial Tears: Over-the-counter artificial tears can help soothe any minor discomfort and keep the eye lubricated.
• Protective Eyewear: If the hemorrhage was caused by trauma or if you are at risk of further injury, consider wearing protective eyewear to prevent recurrence.

If you suspect that your subconjunctival hemorrhage was caused by a more serious underlying condition or if you have recurrent hemorrhages, consult with your eye care professional for further evaluation and management.

Prevention

While subconjunctival hemorrhage may not always be preventable, there are steps you can take to reduce your risk:

• Manage Underlying Conditions: Keep conditions such as hypertension and diabetes under control through proper management and regular medical check-ups.
• Handle Your Eyes Carefully: Be mindful of activities that could potentially injure your eyes, and avoid rubbing or putting pressure on them.
• Be Cautious with Medications: If you are taking blood-thinning medications, follow your doctor’s recommendations closely and be aware of any potential side effects.

Photo by Ksenia Chernaya

Subconjunctival hemorrhages, though alarming in appearance, are typically a benign condition that resolves on its own. If you experience any sudden changes in your vision or eye health, it’s always best to consult with your eye care professional for guidance and treatment.