Subconjunctival hemorrhage

Definition

A subconjunctival hemorrhage (sub-kon-junk-TIH-vul HEM-uh-rij) occurs when a tiny blood vessel breaks just underneath the clear surface of your eye (conjunctiva). You may not realize you have a subconjunctival hemorrhage until you look in the mirror and find the white part of your eye is bright red.

The conjunctiva can't absorb the blood very quickly, so the blood is trapped under this transparent surface. A subconjunctival hemorrhage may worry you, but it's usually a harmless condition that disappears within 10 to 14 days.

Subconjunctival hemorrhage often occurs without any obvious harm to your eye, or it may be the result of a strong sneeze or cough that caused a broken blood vessel. You don't need any specific treatment for a subconjunctival hemorrhage.

Symptoms

The most obvious sign of a subconjunctival hemorrhage is a bright red patch on the white (sclera) of the eye. Despite its bloody appearance, a subconjunctival hemorrhage should cause no change in your vision, no discharge from your eye and no pain. Your only discomfort may be a scratchy feeling on the surface of your eye.

When to see a doctor
If you have recurrent subconjunctival hemorrhages or other bleeding, talk to your doctor.

Causes

The cause of subconjunctival hemorrhage is usually unknown. However, the following actions may be enough to cause a small blood vessel to rupture in your eye:

  • Violent coughing
  • Powerful sneezing
  • Heavy lifting
  • Vomiting

In some cases, subconjunctival hemorrhage may result from an eye injury, such as from:

  • Roughly rubbing your eye
  • Severe eye infection
  • Eye or eyelid surgery

Risk factors

Risk factors for subconjunctival hemorrhage include:

  • Diabetes or high blood pressure (hypertension)
  • Illnesses that causes severe coughing or sneezing
  • Certain blood-thinning medications, such as warfarin (Coumadin) and aspirin
  • Herbal supplements, such as ginkgo, that increase the potential for bleeding in the eye

Subconjunctival hemorrhage can also occur among newborns, who may be subjected to pressure changes during delivery.

Complications

While you may feel self-conscious about the appearance of your eye, health complications from a subconjunctival hemorrhage are rare.

Tests and diagnosis

The best way for your doctor or eye doctor (ophthalmologist) to diagnose subconjunctival hemorrhage is by looking at your eye. You'll likely need no other tests. However, your doctor may ask you some questions about your general health, take your blood pressure and obtain a routine blood test to make sure you don't have a potentially serious bleeding disorder.

Treatment and drugs

You may want to use eyedrops, such as artificial tears, to soothe any scratchy feeling you have in your eye. Beyond that, the blood in your eye will absorb within 10 to 14 days, and you'll need no further treatment.

Prevention

There's no known way to prevent subconjunctival hemorrhage unless there is a clearly identifiable cause for the bleeding, such as might occur if you're taking blood-thinning medications.

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