17713 Subconjunctival Hemorrhage

Overview

A subconjunctival hemorrhage is a small break in a blood vessel under the clear surface of your eye. The blood spreads out and makes the white part of your eye look bright red or dark red. It looks alarming, but it is usually harmless and goes away on its own within a week or two.

Yes, subconjunctival hemorrhage is quite common. Many people experience it at some point, often without knowing what caused it.

It can affect anyone, but it is more common in adults, especially those who strain their eyes, have high blood pressure, or take blood-thinning medicines. It can also happen after a minor eye injury.

Symptoms

Common symptoms

• A bright red or dark red patch on the white part of the eye
• The red area may be small or cover a large part of the eye
• No pain, itching, or change in vision in most cases
• Sometimes a scratchy feeling, like something is in the eye

Symptoms in children

• The same red patch on the white of the eye
• Children often have no symptoms and may not notice it
• It can happen after coughing, sneezing, or rubbing the eye hard

Symptoms in older adults

• The red patch may last a little longer and is often more visible
• Older adults may have repeated episodes if they have high blood pressure or take blood-thinning medicine
• If it happens with a headache or vision problems, it needs medical attention

Causes

Main causes

• Coughing, sneezing, or straining too hard
• Minor trauma to the eye, like rubbing it or getting something in it
• Lifting heavy objects or intense exercise
• High blood pressure
• Taking medicines that thin the blood, such as aspirin or anticoagulants

Risk factors

• High blood pressure (hypertension)
• Diabetes
• Blood-thinning medicines
• Eye surgery or LASIK
• Contact lens use, if not inserted carefully
• Being older, when blood vessels are more fragile

When to see a doctor

See a doctor urgently if:

• If you have pain, vision changes, or the eye swells
• If the hemorrhage appears after a head injury
• If you have bleeding disorders or are on blood-thinning medication and get frequent episodes

Book a routine appointment if:

• If it is your first time and you want reassurance
• If the red patch lasts longer than two weeks
• If you have repeat episodes even without straining

Diagnosis

A doctor (GP, optician, or eye specialist) can usually diagnose a subconjunctival hemorrhage simply by looking at your eye. They will ask about your symptoms, any recent injury, and your medical history.

Tests that may be done

• A visual test to check your vision is not affected
• A slit-lamp exam, which uses a bright light and microscope to look at the front of your eye in detail
• A blood pressure check if high blood pressure is suspected
• Blood tests only if you have frequent bleeding or other signs of a bleeding disorder

What to expect at your appointment

The doctor will reassure you that the red patch is not harmful. They will explain that the blood will be absorbed naturally over 1 to 2 weeks. You may be told to watch for any unusual symptoms, but usually no further tests are needed.

Treatment

There is no specific medical treatment for a subconjunctival hemorrhage. It resolves on its own. The goal is to keep the eye comfortable and to follow any advice from your doctor about underlying conditions.

Self-care at home

• Apply a cold compress (a clean cloth with cold water) to your closed eyelid for the first day to help soothe any irritation
• Do not rub your eye
• Use artificial tears (lubricating eye drops) from the pharmacy if your eye feels scratchy – ask your pharmacist for advice
• Avoid heavy lifting or straining for a few days
• If you wear contact lenses, give your eye a break until the red patch starts to fade
• If you take blood-thinning medicines, talk to your doctor before making any changes

Medical treatments

Your doctor may ask you to manage high blood pressure or other underlying conditions if they are present. There are no eye drops or ointments specifically prescribed for a subconjunctival hemorrhage. In very rare cases, if bleeding is frequent or severe, your doctor may refer you to an eye specialist for further evaluation.

When is surgery considered?

Surgery is not needed for a subconjunctival hemorrhage.

Living with this condition

You can live normally with a subconjunctival hemorrhage. The redness will fade gradually, and your eye should feel fine. If you are self-conscious, you can wear glasses or sunglasses to hide it a little.

Lifestyle tips

• Protect your eyes from injury by wearing safety glasses during sports or DIY work
• Manage your blood pressure with a healthy lifestyle and regular check-ups
• Avoid rubbing your eyes, especially when tired or after contact lens removal

Diet and exercise

A healthy diet with plenty of fruits and vegetables can strengthen blood vessels. When exercising, try not to strain too hard – if you lift weights, breathe out as you lift rather than holding your breath. This can reduce pressure in your head and eyes.

Mental health and emotional wellbeing

A red eye can be worrying or embarrassing, but it is temporary and harmless. Most people feel better once they understand what it is. If you feel anxious about it, talk to your doctor or a trusted health professional.

Prevention

You cannot always prevent a subconjunctival hemorrhage, but you can lower your risk by protecting your eyes, controlling high blood pressure, and avoiding straining when you lift or cough. If you take blood-thinning medicine, keep your regular check-ups and discuss any concerns with your doctor.

Vaccines

There is no vaccine to prevent a subconjunctival hemorrhage.

Screening programmes

If you have repeated hemorrhages, your doctor may check your blood pressure and bleeding risk. Regular eye exams can also help detect any underlying problems.

Complications

If left untreated

• In nearly all cases, a subconjunctival hemorrhage causes no complications and clears without treatment
• If the bleeding is due to high blood pressure, untreated high blood pressure can lead to more serious eye problems or strokes
• Very rarely, repeated hemorrhages without a cause may signal a bleeding disorder that needs medical evaluation

Long-term outlook

The outlook is excellent. The blood patch will fade by itself over 1 to 2 weeks, starting with a yellowish color that then disappears. Your eye will go back to normal without any scarring or permanent vision change.

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