Subconjunctival Hemorrhage

What is a subconjunctival hemorrhage?

You’ve got a blood spot on your eye. Don’t panic yet. It may just be a subconjunctival hemorrhage. That’s a complicated name for a rather minor condition. Subconjunctival hemorrhage is the term for a broken blood vessel that bleeds on the surface of your eye.

The clear membrane that lines the inside of your eyelid and covers the white of your eye is called the conjunctiva. It contains many tiny blood vessels (capillaries) that can break easily. When a break happens, blood can leak under the conjunctiva. The blood causes the white of your eye (sclera) to turn bright red.

If you have a subconjunctival hemorrhage, the blood is trapped in the conjunctiva, so it doesn’t move and can’t be wiped away. But since the blood isn’t on your cornea or the inside of your eye, your vision isn’t affected.

The red spots caused by subconjunctival hemorrhage can look scary. But most cases don’t cause any other symptoms or need treatment. They typically go away on their own within a few weeks.

What are the symptoms of a subconjunctival hemorrhage?

Other than the red spot in your eye, there are no subconjunctival hemorrhage symptoms. It doesn’t cause pain or swelling, and it doesn’t affect your vision. Most people who have a subconjunctival hemorrhage don’t even know it until they look in a mirror or someone tells them. There’s a chance you could have mild irritation, but there should be no discharge or any other symptoms.

What usually causes a subconjunctival hemorrhage?

Some activities and health conditions can briefly raise the blood pressure in your veins. This quick rise in pressure can cause the blood vessels on your eyes to break. These conditions may include:

• Straining (during coughing, sneezing, vomiting or while using the toilet).
• Injury to your head or eye, including infection.
• Lifting, pushing or bending forward.
• Rubbing your eye too hard.
• Wearing contact lenses.
• Taking medications, including blood thinners and a cancer drug called interferon.

Less common subconjunctival hemorrhage causes include:

• Diabetes.
• High blood pressure.
• Blood clotting disorders.

Subconjunctival hemorrhages sometimes happen without a direct cause (a healthcare provider might say they happened idiopathically).

What are the risk factors for a subconjunctival hemorrhage?

Risk factors for subconjunctival hemorrhage include:

• Age: People age 65 and older are most at risk of having a subconjunctival hemorrhage. This is especially true for people with vascular conditions such as high blood pressure and/or diabetes.
• Contact lens wearing: People who wear contact lenses are also at an increased risk of subconjunctival hemorrhages. Contact lens wearers have a higher tendency to have diseases that affect their conjunctiva. These diseases can cause dryness and friction, which can lead to inflammation and broken blood vessels.
• Eye surgery: People who’ve had eye surgery, such as cataract surgery, are also at an increased risk of subconjunctival hemorrhage.

What are the potential complications of a subconjunctival hemorrhage?

In most cases, subconjunctival hemorrhages are harmless and don’t cause any complications. Rarely, they may be a sign of a serious underlying disorder, such as:

• Vascular disease.
• A bleeding or blood clotting disorder.
• Severe asthma.
• Non-accidental trauma.
• Severe eye (orbital) trauma.

How is a subconjunctival hemorrhage diagnosed?

A healthcare provider or eye care specialist can diagnose a subconjunctival hemorrhage by looking at your eye. Your provider may check your blood pressure, especially if you have other areas of bleeding or bruising.

What is the fastest way to heal a subconjunctival hemorrhage?

Subconjunctival hemorrhage treatment usually isn’t necessary. Artificial tears (eye drops) can help relieve eye irritation if it occurs. Most broken blood vessels heal within two weeks. Larger spots may take longer to go away. As the blood clears up, the color of the area may change, like a fading bruise.

Contact your eye care specialist if you have eye pain. This could be a sign of other conditions that are more serious, such as a hyphema — blood collecting in front of your iris (the colored part of your eye).

If broken blood vessels appear in your eyes often, your provider or eye care specialist may want you to get tests to try to identify an underlying cause. Sometimes, disorders related to blood clotting like hemophilia or von Willebrand disease make subconjunctival hemorrhage more likely.

Can subconjunctival hemorrhages be prevented?

If you have risk factors for subconjunctival hemorrhages, you can take steps to prevent broken blood vessels, including:

• Keeping your contact lenses clean.
• Wearing proper protective eyewear for all sports, activities or work.
• Checking with your healthcare provider if you have a bleeding disorder.

What can I expect if I have a subconjunctival hemorrhage?

Most subconjunctival hemorrhages go away on their own within two weeks. The white of your eye may have a yellowish tint as the issue resolves, but you should have no vision problems.

Subconjunctival hemorrhages can return randomly (spontaneously). About 10% of people with no known risk factors have a recurrence (the hemorrhage returned). That rate is higher for people with known risk factors, such as taking blood thinners.

When should I see a doctor for subconjunctival hemorrhage?

Most cases of subconjunctival hemorrhage will go away on their own with no need for treatment. However, if you have pain or other symptoms, call your healthcare provider or eye care specialist.

When should I be concerned about a subconjunctival hemorrhage?

Subconjunctival hemorrhages may look alarming, but they’re usually no cause for concern. If you have other facial or eye injuries, you should visit a healthcare provider. If you have repeated cases of subconjunctival hemorrhage, see your provider. You may have a more serious underlying condition.

A note from Cleveland Clinic

You may look like a character in a horror movie, but there’s no need to scream. A subconjunctival hemorrhage is a common eye condition that isn’t dangerous and should go away on its own. If you have pain along with the red spot, or if you have repeated cases of subconjunctival hemorrhage, see your healthcare provider. You may have a more serious underlying condition.