Subconjunctival Hemorrhage?

If you have ever woken up and the white part of your eye has a bright red spot, it can be startling, especially if you have not injured your eye. The blood spot might be due to a subconjunctival hemorrhage.
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When we think of blood in the eye, we might think it mostly happens due to an eye injury. A subconjunctival hemorrhage can occur due to trauma to the eye, but it may also develop for 

other reasons. ​October is Eye Injury Prevention Month, and it is an excellent time to learn what causes this common injury and how to prevent it. 
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What is a Subconjunctival Hemorrhage? 

The conjunctiva is the membrane that covers the white part of the eye. It has many fragile, small blood vessels, which can break easily. A hemorrhage involves bleeding. A subconjunctival hemorrhage is bleeding on the white surface of the eye.

When the small blood vessels break, the blood leaks into the white part of the eye. Subconjunctival hemorrhages are usually painless and don’t involve inflammation or discharge from the eye. They also do not interfere with vision.

Typically, the only symptom is blood on the conjunctiva. Some people may feel a slight irritation as if something was in their eye. A subconjunctival hemorrhage can involve one or more tiny dots of blood, or it can cover the entire white part of the eye.  
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Causes of a Subconjunctival Hemorrhage

According to the American Academy of Ophthalmology, a subconjunctival hemorrhage can have several different causes, including the following:

Trauma: Injuries to the eye can cause the blood vessels to rupture and lead to bleeding in the conjunctiva. Various types of injuries to the globe of the eye or the orbital bone can cause a hemorrhage. Even a minor trauma, such as rubbing the eye too hard, can cause the blood vessels to break.

Coughing and sneezing: Something as simple as coughing or sneezing may also lead to a subconjunctival hemorrhage. What happens is the transient increase in blood pressure in the veins during a sneeze or cough causes the vessels to break.

Straining: Straining too hard also increases the pressure in the veins, which can lead to a burst vessel. For instance, straining due to constipation or when lifting something heavy may lead to a subconjunctival hemorrhage.

Medication side effects: Certain types of medication, such as blood thinners, can increase your risk of developing a subconjunctival hemorrhage. Examples of blood thinners include warfarin and heparin. Some over the counter anti-inflammatory drugs, such as ibuprofen can also thin the blood. 
There are other less common causes of subconjunctival hemorrhages, including blood clotting disorders and rare diseases, such as ocular amyloidosis. 

Although anyone can develop a subconjunctival hemorrhage, there are certain factors that increase your risk. For example, people that have diabetes or high blood pressure are at an increased risk of developing a subconjunctival hemorrhage. Wearing contact lenses and having arteriosclerosis also increases your risk. 

Subconjunctival Hemorrhage Treatment 

In most cases, a subconjunctival hemorrhage does not require treatment. The blood is absorbed by the body, and the redness typically clears in a week or two. If a mild irritation is present, over the counter eye drops may help. 
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Prevention 

Preventing a subconjunctival hemorrhage is not entirely possible since the cause is not always known. But there are a few things you can do to decrease your risk.

• Avoid rubbing your eyes vigorously.
• Wear proper eye protection to avoid injury.
• If possible, avoid taking medications that thin the blood. (But do not stop taking medications until talking with your doctor.)
• Don’t poke around in your eye if you get something in it. Instead, try to flush the foreign body out with water. 

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When to See a Doctor  

Although medical treatment is usually not needed for a subconjunctival hemorrhage, there are times when it is important to see a doctor, such as in the following instances:

• Repeated or frequent subconjunctival hemorrhages
• A hemorrhage after trauma to the eye
• Pain or vision loss with the hemorrhage
• A subconjunctival hemorrhage that does not clear up in two weeks

If you have any questions about a subconjunctival hemorrhage or you want to schedule an exam with one of our eye doctors, please phone us at 508-746-8600.