Subconjunctival Hemorrhage

A subconjunctival hemorrhage occurs when a small blood vessel located between the sclera (the white area of the  eye) and the conjunctiva (the lining of the surface of an eye) breaks and covers the sclera with blood, similar to a bruise under the skin. Unlike broken blood vessels located under the skin, which will appear to be black, green or blue, a subconjunctival hemorrhage located under the clear conjunctiva has a bright red appearance to begin with and slowly fades to orange and yellow, as the tissue of the eye absorbs the blood.

Subconjunctival Hemorrhage Symptoms

A subconjunctival hemorrhage is usually painless and will generally go unnoticed until the person looks in the mirror or someone else points out the red spot on their eye. Subconjunctival hemorrhage has few symptoms and is not dangerous, mostly affecting a person’s appearance and sometimes his or her self-esteem. The hemorrhage, however, can cause a feeling of eye awareness when blinking or a full sensation on the surface of the eye. It can also cause minor irritation or a feeling of grittiness in the eye. A subconjunctival hemorrhage should not cause pain, affect vision, or lead to any changes in eye discharge.

Subconjunctival Hemorrhage Causes and Risk Factors

The specific cause of subconjunctival hemorrhage is not always certain. The blood vessels of the eyes are extremely delicate and rupture easily, and can break under the pressure of violent coughing, a powerful sneeze, vomiting, or strain from strenuous activities like weight lifting. Subconjunctival hemorrhage can also result from an injury to the eye as a result of inserting contact lenses improperly, excessive eye rubbing, or some other cause. Viral or bacterial infections of the eye such as conjunctivitis can also cause a subconjunctival hemorrhage.

Certain medical conditions or medications can predispose an individual to recurrent subconjunctival hemorrhages. These conditions include high blood pressure or hypertension, diabetes and blood clotting disorders. Blood thinning medications like aspirin or Coumadin can also be a culprit.

Diagnosis and Treatment

Your eye care professional will diagnose subconjunctival hemorrhage by observation. If it is determined that the cause of the subconjunctival hemorrhage is injury or trauma to the eye, a more thorough eye exam will be necessary to check for further damage. Like bruises on the skin, subconjunctival hemorrhages will clear up on their own without additional treatment. The blood will eventually absorb back into the eye and disappear. If the hemorrhage is caused by an infection or underlying medical condition, however, treatment for that underlying medical problem will be necessary.

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