What is a Subconjunctival Hemorrhage

Frequently I have patient’s come into the office because their eye is blood red. Most of the time, these patients don’t even notice it themselves. Usually they will say “My husband/wife/etc. looked at me and freaked out!” These subconjunctival hemorrhages look really bad, but they actually come without symptoms, other than redness, and are typically not a sign of anything going on medically. 

So, what exactly is a subconjunctival hemorrhage? It is basically a bruise on the white part of the eye. The eye’s conjunctiva has lots of tiny blood vessels that can break and bleed. When you have a bruise on other parts of the body, your skin covers it which gives it the blue/purple/green coloring. On the eye, since there is no skin, you are seeing the actual blood pooling. They look very scary but are usually harmless and heal on their own. 

What kind of symptoms can you expect?

There are usually no other symptoms other than the eye looks blood red. In fact, like I said earlier, someone else may notice it before you do or you may not notice until you look in the mirror. Occasionally it can cause some very mild irritation. 

What Causes Subconjunctival Hemorrhages?

These can be caused by coughing, sneezing, straining, or other similar actions because it will raise blood pressure in the veins which causes the capillaries to break and bleed. 

Trauma can also cause a subconjunctival hemorrhage. Surprisingly enough, rubbing your eyes too hard may also cause the blood vessel to break!

Other more uncommon causes include:

  • Diabetes
  • Hypertension
  • Blood thinning medications like aspirin or Coumadin

Very rarely, subconjunctival hemorrhages can be a sign of a blood clotting disorder or other blood problem that affects the body. 

Subconjunctival Hemorrhages Treatment

A subconjunctival hemorrhage should resolve on its own.  Small ones may only take a few days but larger ones can take a few weeks. It may look worse before it looks better as gravity pulls the blood down.

If the eye is irritated, artificial tears can be used. Here is a link to my favorite artificial tear.

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