Our eyes are intricate and delicate structures that are essential for how we perceive the world. While it’s easy to take your vision for granted, occasional abnormalities can occur and when they do, they often cause serious alarm and concern.
One such unsettling occurrence is the appearance of a subconjunctival hemorrhage, or the presence of blood in the eye.
The presence of a subconjunctival hemorrhage can be especially alarming when it shows up in the conjunctiva, or the thin, clear membrane that protects the eye, the inside of the eyelid, and the sclera (the white part of the eye).
While the presence of blood in your eye can be quite alarming at first glance, understanding its causes, risk factors, and potential treatments can help alleviate fears and even improve your overall eye health.
A subconjunctival hemorrhage occurs when tiny blood vessels beneath the conjunctiva break and leak blood into the eye. This condition is often referred to as “eye bleeding” and can result in the appearance of a bright red patch on the white portion of the eye. While the appearance of blood in the eye may be disconcerting, subconjunctival hemorrhages are generally harmless and do not typically pose any threat to vision.
While a subconjunctival hemorrhage can occur to people of any age, they are more common in older adults.
There are several factors that contribute to the appearance of subconjunctival hemorrhage. Factors causing the appearance of blood in the eye can range from minor accidents to more serious underlying medical conditions and include:
Trauma or injury: One of the most common causes of subconjunctival hemorrhage is minor trauma or injury to the eye. Rubbing the eye vigorously, sneezing, coughing, or even inserting and removing contact lenses too forcefully can cause blood vessels to rupture and blood to appear in the eye.
Straining: Activities that involve straining, such as heavy lifting, intense bouts of coughing, or even constipation, have been found to lead to an increase in blood pressure in the eye’s blood vessels, making them more susceptible to rupture.
Eye surgery: Certain eye surgeries, like LASIK or cataract surgery, can inadvertently damage blood vessels, leading to a subconjunctival hemorrhage.
Medical conditions: Certain medical conditions can increase the likelihood of subconjunctival hemorrhages. Underlying medical conditions like hypertension, diabetes, and certain autoimmune diseases—including lupus and rheumatoid vasculitis—can weaken blood vessels and increase the risk of a hemorrhage. Other medical conditions that affect blood clotting, such as hemophilia or von Willebrand disease, can also make blood vessels more prone to rupture.
Medications: Blood-thinning medications, such as aspirin and anticoagulants, slow the body’s ability to clot and increase the likelihood of bleeding throughout the body, including the eye.
Eye strain: Prolonged periods of reading, staring at screens, or performing close-up work can cause eye strain and potentially contribute to the development of a subconjunctival hemorrhage.
Eye infections: In some cases, eye infections or severe allergies that lead to persistent itching and rubbing of the eyes can result in the development of subconjunctival hemorrhages. The constant irritation has been found to weaken blood vessels and trigger their rupture.
The most prominent symptom of a subconjunctival hemorrhage is the appearance of a bright red patch on the white part of the eye. This area can vary in size and shape, ranging from a small spot to a larger, more widespread area of redness. Apart from the visible signs, individuals with a subconjunctival hemorrhage usually experience no discomfort, pain, or change in vision.
While subconjunctival hemorrhages can affect anyone at any time, certain risk factors can increase the likelihood of their occurrence. These factors include:
Age: As we age, the blood vessels in our eyes become more fragile, making older individuals more susceptible to these types of hemorrhages.
Medical history: Those with a history of hypertension, diabetes, or other medical conditions that affect the integrity of the blood vessel are at a higher risk for experiencing a subconjunctival hemorrhage.
Use of blood-thinning medications: Individuals taking medications that interfere with the body’s ability to form blood clots, including aspirin, Coumadin, or Plavix, are more prone to experiencing bleeding events throughout the body, including the eyes.
Eye trauma: Any history of eye trauma or surgery can cause the blood vessels in and around the eyes to weaken and become more vulnerable to experiencing a hemorrhage.
A subconjunctival hemorrhage is typically diagnosed through a visual examination by a healthcare professional. No specific treatment is required for this condition, as it usually resolves on its own within one to two weeks. However, certain steps can be taken to promote healing and prevent complications, including:
Artificial tears: Lubricating eye drops can provide pain relief and prevent dryness that may occur as the blood is reabsorbed.
Avoid irritants: To prevent further irritation, avoid rubbing the affected eye and refrain from using contact lenses until the hemorrhage has completely healed.
Monitor blood pressure: When hemorrhage is caused by high blood pressure, it is essential to monitor and manage blood pressure levels to prevent future occurrences.
Consult with your healthcare professional: If the subconjunctival hemorrhage is accompanied by pain, changes in vision, or occurs frequently, it is very important that you consult an eye specialist to rule out any underlying conditions.
While it’s not always possible to prevent the occurrence of a subconjunctival hemorrhage, there are steps that can be taken to minimize the risk. These steps include:
Being gentle with your eyes: Avoid rubbing your eyes aggressively, and be very careful when inserting or removing contact lenses.
Protecting your ryes: When engaging in activities that could lead to eye trauma, such as sports or DIY projects, always wear the correct protective eyewear.
Managing underlying health conditions: Should you have medical conditions that affect blood clotting or blood pressure, work closely with your healthcare provider to manage them effectively.
While subconjunctival hemorrhages are generally harmless, there are instances when medical attention should be sought, these include:
Pain: If the hemorrhage is accompanied by pain or discomfort, it may be an indication of an underlying issue that requires immediate medical attention.
Vision changes: If the presence of blood in the eye is accompanied by changes in vision, it could be indicative of a more severe and immediate medical problem, including stroke or another type of serious cardiac event.
Recurring hemorrhages: The frequent occurrence of subconjunctival hemorrhages could also be a sign of a more serious underlying medical condition that needs to be addressed, such as atherosclerosis, hypertension, or diabetes.
Underlying medical conditions: If you already have underlying medical conditions, are on blood-thinning medications, or are experiencing other symptoms that cause you to be concerned about your eye health, it’s wise to consult a healthcare professional to ensure there are no complications.
Accompanying symptoms: If the blood in the eye is accompanied by any other symptoms, such as light sensitivity, discharge, or a change in eye color, seeking medical attention is recommended.
Recent trauma: If the blood in the eye is a result of recent trauma, particularly if it is accompanied by other signs of injury, it’s important to have your eye examined by a medical profession to rule out any serious or undetected damage.
The presence of blood in the eye can be alarming, but in most cases, it’s a benign occurrence that poses no threat to your vision or overall long-term eye health. Subconjunctival hemorrhages may appear dramatic and serious, but they are typically self-limiting and require minimal intervention.
By understanding the potential causes, risk factors, and appropriate steps for managing and preventing subconjunctival hemorrhages, you can maintain eye health and alleviate any concerns that might arise from this common and usually harmless condition.
If you’re ever in doubt or experience severe symptoms, it’s always wise to seek the guidance of a medical professional to ensure the health and wellbeing of your eyes.