Subconjunctival Hemorrhage

A subconjunctival hemorrhage (sub-kun-JUNK-tih-vul HEM-uh-ruj) appears as a bright-red patch in the white portion of your eye. It happens when a small blood vessel ruptures and bleeds within the clear surface of your eye (conjunctiva). 

This may occur without any injury to your eye, and you may not even be aware of your subconjunctival hemorrhage until you look into the mirror. The conjunctiva is unable to absorb the blood very quickly because of which the blood remains confined under this transparent surface. 

A subconjunctival hemorrhage may be worrisome, but it is usually a harmless condition that resolves within one or two weeks. It may often be a result of a strong sneeze or cough that caused a blood vessel to break. There is no specific treatment for a subconjunctival hemorrhage.

The most apparent symptom of a subconjunctival hemorrhage is a bright red patch on the white portion (sclera) of your eye. However, the hemorrhage does not lead to changes in your vision, and there is no pain or discharge from your eye.

There may be itchiness felt on the surface of your eye. 

When to see a Doctor?

Consult your doctor if you encounter recurrent subconjunctival hemorrhages or other bleeding.

One of these factors may be the cause of your subconjunctival hemorrhage:

• Violent sneezing and coughing,
• Heavy lifting,
• Vomiting.

 In some cases, subconjunctival hemorrhage may result from: 

• Rubbing your eyes vigorously,
• Severe viral eye infection, 
• Trauma from a foreign object injuring your eye,
• High blood pressure or taking medications such as blood thinners,
• Certain eye surgeries.

A subconjunctival hemorrhage may also occur in newborns. This may be due to the pressure changes occurring across the infant's body during the process of childbirth.

Making a diagnosis of subconjunctival hemorrhageis done by physical appearance of your eye.

You may consult your family doctor or a general practitioner initially. After evaluation, you may be referred to an ophthalmologist if required. It is always a good idea to be well prepared for your appointment. Here is some information that may help you to get ready for your appointment.

What you can do?

Prepare a list of the following:

• Symptoms you are experiencing, including those that may seem unrelated to the reason of your appointment. 
• Key personal information, including any major stresses or recent life changes. 
• All medications, vitamins or supplements that you take regularly.

Write down questions to ask your doctor. As the time with your doctor will be brief, prepare a list of questions in the order of most important to least important. For subconjunctival hemorrhage, some basic questions to ask your doctor include: 

• What is the most likely cause of my problem? 
• What are other possible causes of my symptoms? 
• Which of the diagnostic tests do I need? 
• Is my condition likely to be temporary or chronic? 
• What is the best treatment plan? 
• Are there any alternatives to the primary approach?
• How can I best manage my other health conditions together? 
• Are there any restrictions that should be followed? 

What to expect from your doctor?

Your doctor may ask you a number of questions such as:

• When did you first notice your problem?
• Do you have any other symptoms?

Most of the times, no other tests will be needed. 

Your doctor may ask questions to gather information regarding your general health, conduct an examination of your eye, measure your blood pressure, and order a routine blood test to determine whether you have a serious bleeding disorder.

Subconjunctival Hemorrhage will resolve within about one to two weeks, and you will need no treatment.

You may use eyedrops, such as artificial tears that can be instilled into your eyes on your own. This can help soothe the itchy feeling or irritation you may have in your eyes. 

There is no known preventive measure to avoid subconjunctival hemorrhage. You can avoid rubbing your eyes too hard as it can cause minor trauma to your eyes. 

If there is an apparent cause for the bleeding such as blood thinning medications or a bleeding disorder, treatment of the underlying cause could help in preventing subconjunctival hemorrhage.

The risk factors for subconjunctival hemorrhage include: 

• Diabetes,
• High blood pressure (hypertension),
• Certain blood-thinning medications, such as warfarin (Coumadin) and aspirin,
• Bleeding disorders.

A subconjunctival hemorrhage rarely causes any health complications, except for the appearance of your eyes that makes you self-conscious. 

In elderly people, a total subconjunctival hemorrhage may be a sign of a serious vascular disorder.