Subconjunctival Hemorrhage Symptoms & Treatments

A subconjunctival hemorrhage is an eye condition characterized by a bright red patch appearing on the white part of the eye. While it may look severe, it is typically harmless and resolves on its own without medical intervention.

However, understanding the symptoms, causes, and treatments can help alleviate concerns patients may have and guide them toward proper eye care.

A subconjunctival hemorrhage is a condition where blood spots appear in the clear part of a patient's eye. Each eye has a clear membrane called the conjunctiva. This membrane lines the inside of the patient's eyelids and covers the sclera (white part of the eye).

The conjunctiva has many tiny blood vessels capable of breaking. When a break occurs, blood can leak under the conjunctiva. This part of the eye cannot absorb blood quickly so blood gets trapped, causing the white part of the eye to turn red.

While the appearance can be alarming, a subconjunctival hemorrhage is rarely a sign of a severe underlying condition. Blood is trapped in the conjunctiva, but since the blood typically doesn't reach the cornea or the inside of the eye, a patient's vision is rarely affected.

The most noticeable symptom of subconjunctival hemorrhage is the appearance of a red spot on the white part of the eye. The spot typically does not cause serious pain or affect the patient's vision. In fact, patients may not notice anything until looking in a mirror.

Patients with a subconjunctival hemorrhage rarely experience pain, discharge, or changes in vision. However, in certain cases they may detect symptoms such as mild irritation, scratchy sensations, and discomfort in their eye.

A subconjunctival hemorrhage is often caused by the rupture of small blood vessels in the eye. This rupture may be the result of certain activities and conditions that briefly raise blood pressure in a patient's vein, and can cause capillaries to break: These include:

• Straining activities: Coughing, vomiting, and sneezing can all cause subconjunctival hemorrhage.

• Heavy lifting: Lifting or pushing a heavy object can cause tension which leads to subconjunctival hemorrhage.

• Eye trauma: Foreign objects in the eye or injuries from sports or other physical activity can be responsible for the condition.

• Contact lens usage: inserting and removing contact lenses can create pressure which leads to subconjunctival hemorrhage.

• Rubbing eye: Too much pressure on the eye can cause capillaries to break

Although less common, certain eye conditions and medications may also cause a subconjunctival hemorrhage:

• Diabetes

• High blood pressure

• Medications that can cause bleeding such as aspirin and blood thinners.

In rare cases problems with a patient’s blood such as a blood clotting and other bleeding disorders may cause subconjunctival hemorrhage.

Certain segments of the population are at a higher risk of developing a subconjunctival hemorrhage.

• People over 65: Once patients cross the age of 65 they are at a higher risk. This is especially true if they have a vascular condition like diabetes or high blood pressure.
  

• Contact lens users: If a patient wears contact lenses they are at a greater risk of subconjunctival hemorrhage. In general, contact users develop more conditions that affect their conjunctiva and can lead to inflammation and broken blood vessels.

• People who have had eye surgery: patients who have undergone an eye surgery like cataract surgery, are also at an increased risk.

In general subconjunctival hemorrhage is a harmless condition which will go away on its own, without causing serious damage to the eye. However, in rare cases subconjunctival hemorrhage may be a symptom or warning sign of a more serious eye condition. These may include:

• A vascular disease

• Severe orbital trauma

• Non-accidental or minor trauma

• Severe asthma

• A bleed or blood clotting disorder

Diagnosis will begin with a visual exam of the affected eye. An eye doctor or specialist will be able to make the diagnosis by looking at the eye. To get further information, the patient's eye care professional may ask about:

• Recent trauma or injury

• Medical history, including hypertension and diabetes

• Use of blood-thinning medications

• Symptoms like pain, vision changes, or discharge

In rare cases, additional tests may be required to see if subconjunctival hemorrhage is a symptom of a more serious medical condition:

• Blood Pressure Measurement: To check for hypertension.

• Blood Tests: To assess clotting function and detect underlying disorders.

• Slit-Lamp Examination: To examine the eye in detail.

Most cases of subconjunctival hemorrhage require no medical treatment. The broken vessel typically heals in around two weeks. Similar to a bruise on the body, the color of the affected area may change as the eye begins to heal.

Eye doctors may prescribe patients artificial tears or lubricating eye drops to relieve irritation and dryness that accompanies subconjunctival hemorrhage. Patients may also use a cold compress to reduce swelling.

As the eye heals, doctors will typically ask patients to refrain from touching or rubbing their eye, as this can aggravate the condition and cause further bleeding.

A stroke disrupts the blood supply to the brain's visual processing areas, leading to tunnel vision and other forms of vision loss.

Stroke symptoms are not exclusively limited to a patient’s vision. In addition to visual disruption, symptoms include weakness or numbness on one side of the body, confusion, difficulty speaking, and dizziness.

A stroke is considered a medical emergency. If left untreated it can have serious repercussions including brain damage. Thus, patients should seek immediate medical attention to restore blood flow and prevent further damage.

In most cases subconjunctival hemorrhage will go away without medical intervention. If the condition persists longer than two weeks, patients should follow up with a medical professional.

Patients should schedule an appointment with their eye doctor if they are experiencing pain or vision changes or having recurrent subconjunctival hemorrhages.

Not all cases of subconjunctival hemorrhage are preventable. However, patients can take a a number of steps to reduce the risk of developing the condition:

• Protective Eyewear: During sports or hazardous work

• Gentle Eye Care: Avoid aggressive rubbing

• Healthy Lifestyle: Maintain a balanced diet and exercise regularly

• Avoid Excessive Straining: Practice proper lifting techniques and avoid activities that may cause coughing, vomiting, or sneezing.