Subconjunctival Hemorrhage (Bleeding in Eye)

Subconjunctival Hemorrhage Overview

The conjunctiva is the thin, moist, clear membrane that covers the white part of the eye (called the sclera). It protects and lubricates the eyeball.

The conjunctiva contains nerves and many small blood vessels. These blood vessels are fragile and may rupture or burst easily, resulting in a subconjunctival hemorrhage (bleeding under the conjunctiva). A subconjunctival hemorrhage appears as a bright red or dark red patch on the sclera.

Subconjunctival Hemorrhage Causes

Usually, there is no obvious cause for this bleeding underneath the conjunctiva. Often, a person may discover a subconjunctival hemorrhage on awakening.

The following can occasionally result in a subconjunctival hemorrhage:

• Sneezing

• Coughing

• Straining/vomiting

• Eye rubbing

• Trauma (injury)

• High blood pressure

• Bleeding disorder

• Severe eye infection (conjunctivitis)

Subconjunctival Hemorrhage Symptoms

Most of the time, no symptoms are associated with a subconjunctival hemorrhage other than seeing blood over the white part of the eye.

• Very rarely do people experience any pain when the hemorrhage begins. As the hemorrhage resolves, some people may experience a very mild irritation of the eye.

• The hemorrhage itself is an obvious, sharply outlined red spot on the sclera. The entire white part of the eye may be covered by blood.

When to Seek Medical Care

Call your ophthalmologist (a medical doctor who specializes in eye care and surgery) if the subconjunctival hemorrhage does not get better within 2 weeks or if it has happened many times.

Also, call your ophthalmologist if you have a hemorrhage in both eyes at the same time or if the subconjunctival hemorrhage coincides with easy bruising, bleeding gums, or both.

Go to your ophthalmologist immediately if these conditions develop:

• Extreme pain
  
  
• Changes in vision (eg, blurry vision, double vision, difficulty seeing)
  
  
• History of bleeding disorder
  
  
• History of high blood pressure
  
  
• Injury from trauma to the eye

Questions to Ask the Doctor

• Is there any sign of damage to the eye?
  
  
• Will I develop any scarring or permanent vision loss from a subconjunctival hemorrhage?
  
  
• What causes a subconjunctival hemorrhage? 
  
  
• How can I prevent a subconjunctival hemorrhage?

Exams and Tests

Your ophthalmologist takes a concise history of what led up to the subconjunctival hemorrhage and performs an examination. Your blood pressure may also be checked.

If trauma was the cause, a more thorough examination using a slit lamp (a special microscope for examining the eye) will usually be performed.

Subconjunctival Hemorrhage Treatment

Self-Care at Home

Usually, no treatment is needed. Over-the-counter artificial tears can be applied to the eye if mild irritation is present.

The use of aspirin or ibuprofen should be avoided.

Medical Treatment

Usually, no treatment is required. Your ophthalmologist may prescribe artificial tears to ease the irritation.

If the injury is trauma related, your ophthalmologist may need to examine your eye to rule out the possibility of damage to other parts of the eye.

Next Steps Outlook

This condition clears after 1-2 weeks. Usually, recovery is complete, without any long-term problems. Like a bruise, a subconjunctival hemorrhage changes colors (often red to yellow) as it heals.

For More Information

American Academy of Ophthalmology
655 Beach Street
Box 7424
San Francisco, CA 94120
(415) 561-8500

Web Links

American Academy of Ophthalmology

Medem, Inc, Medical Library, Eye Health

Multimedia

Media file 1: Subconjunctival hemorrhage. Photograph courtesy of Lawrence B. Stack, MD, Vanderbilt University.

Synonyms and Keywords

subconjunctival hemorrhage, bleeding in the eye, eye injury, ruptured blood vessels, blood in the eye, bleeding under the conjunctiva, bloodshot eye,conjunctiva, pinkeye,conjunctivitis