Subconjunctival hemorrhage is a condition that occurs when a blood vessel in the eye ruptures, causing blood to leak into the space between the conjunctiva and sclera. The conjunctiva is the clear membrane that lines the inside white part of the eye, while the sclera surrounds the outer white part of the eye consisting of dense connective tissues. There are tiny blood vessels in the conjunctiva, which can sometimes rupture easily and cause blood leakage into the conjunctiva. When the rupture happens, it appears as a bright red spot in the eyes, often referred to as a red eye. This condition can cause discomfort and anxiety, especially when a person is not aware of what it is and its possible causes. In this article, we will be discussing what subconjunctival hemorrhage is, its causes, symptoms, management, and much more.
Causes of subconjunctival hemorrhage
There are various causes of the subconjunctival hemorrhage, ranging from minor to severe. Some of the common causes include coughing, sneezing, vomiting, and straining during bowel movements. Other causes include high blood pressure, blood thinners, blood clotting disorders, blunt trauma to the eye, eye surgery, birth injury, and certain eye conditions such as cataracts. In some cases, subconjunctival hemorrhage can occur without any apparent cause. However, it is essential to identify the underlying cause to prevent recurrence.
Signs and symptoms of subconjunctival hemorrhage
The main symptom of subconjunctival hemorrhage is the appearance of bright red spots in the white part of the eye. These spots are painless and do not affect vision. The patches may be small or cover a large area of the eye, depending on the extent of the bleeding.
In some cases, subconjunctival hemorrhage may be accompanied by mild pain, itchiness, and a sensation of pressure in the eye. However, these symptoms are not common and often resolve on their own.
Management and treatment for subconjunctival hemorrhage
Subconjunctival hemorrhage is a self-limiting condition that often resolves on its own within a few weeks. However, there are some measures that can be taken to manage and treat the condition.
The first step is to identify and address the underlying cause of the hemorrhage. For example, if the hemorrhage is caused by high blood pressure, the blood pressure needs to be controlled. If it is caused by blood thinners, the medication may need to be adjusted or discontinued.
In most cases, no specific treatment is required for a subconjunctival hemorrhage. However, applying a cold compress to the affected eye can help reduce swelling and discomfort. Over-the-counter pain relievers such as acetaminophen or ibuprofen can also be used to relieve pain.
Diagnosis of subconjunctival hemorrhage
Subconjunctival hemorrhage can be diagnosed through a physical examination of the eye. The doctor will examine the eye to determine the extent of the bleeding and identify any underlying conditions that may be causing the hemorrhage. In some cases, blood tests may be required to identify any underlying blood clotting disorders.
There are several risk factors that increase the likelihood of developing subconjunctival hemorrhage. These include high blood pressure, diabetes, blood thinners, blood clotting disorders, blunt trauma to the eye or the head, and sometimes due to infections or wearing contact lenses.1
Subconjunctival hemorrhage is a relatively benign condition that rarely causes complications. However, in rare cases, the bleeding may be severe and affect vision. If the bleeding is caused by an underlying condition such as high blood pressure or a blood clotting disorder, the underlying condition may need to be treated to prevent complications.
How can I prevent subconjunctival hemorrhage?
There are some measures that can be taken to prevent subconjunctival hemorrhage. These include avoiding activities that increase pressure in the eye, such as:
- Straining during bowel movement.
- Avoiding rubbing eyes to prevent local minor trauma
It is also essential to manage underlying conditions such as high blood pressure and blood clotting disorders.
How common is subconjunctival hemorrhage
Subconjunctival hemorrhage is a common condition that affects people of all ages. It is likely more prevalent in young adults (males) who are involved in aggressive workloads. The condition may become prominent with ageing because of the high probability of developing underlying medical conditions such as high blood pressure, diabetes, hyperlipidemia, and certain infections.2,3
When should I see a doctor?
In most cases, a subconjunctival hemorrhage is a self-limiting condition that does not require medical attention. However, if the bleeding is severe, affects vision, or is accompanied by other symptoms such as pain, it is essential to seek medical attention.
Subconjunctival hemorrhage is a condition that occurs when a blood vessel in the eye ruptures, causing blood to leak into the space between the conjunctiva and sclera. The condition is relatively benign and often resolves on its own within a few weeks. However, it is essential to identify and address the underlying cause to prevent recurrence. If the condition persists, then it is advised to see your ophthalmologist to rule out any complications.
- Doshi R, Noohani T. Subconjunctival Hemorrhage [Internet]. www.ncbi.nlm.nih.gov. StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551666/
- Kiratli H, Tarlan. Subconjunctival hemorrhage: risk factors and potential indicators. Clinical Ophthalmology [Internet]. 2013 Jun;1163. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702240/