Subconjunctival Hemorrhage

What is an Subconjunctival Hemorrhage?

A subconjunctival hemorrhage is the result of a breakage of a tiny blood vessel in the conjunctiva of the eye. The conjunctiva is a clear film of tissue that is situated over the white portion of the eye. This condition can occur when there is an injury to the eye, by rubbing the eye or from an infection caused by a virus.

People who take blood-thinning medication or those who have high blood pressure will often have a subconjunctival hemorrhage. Excessive pressure in the eye, from coughing or sneezing, can also cause a blood vessel to break inside the eye.

What are the Symptoms of a Subconjunctival Hemorrhage?

When an individual has a subconjunctival hemorrhage, blood will be noticeable in a small area in the white section of their eye. In some instances, the total white portion of the eye will be filled with blood. Normally there is not any pain associated with this condition, but some people may feel a bit of pressure around their eye and it might feel slightly irritated.

After the first day, the red spot inside the eye will gradually get smaller. Individuals who have a subconjunctival hemorrhage that lasts for up to two weeks should contact a medical professional. Other symptoms that require a visit to a physician include pain in the eye and vision problems.

Subconjunctival Hemorrhage Causes

Subconjunctival hemorrhage occurs when the tiny blood vessels throughout the eye rupture and leak blood. There are many reasons why the blood vessels may rupture.

Firstly, violent coughing, sneezing or vomiting can result in subconjunctival hemorrhage. Similarly, straining, for example when lifting heavy objects, can cause blood vessels in the eye to rupture. This is because these activities cause blood pressure to briefly and suddenly rise. The larger blood vessels throughout the body are unaffected by this, but tiny capillaries like those found in the eye are much more delicate and can therefore rupture more easily. Individuals with high blood pressure tend to be more prone to subconjunctival hemorrhage from coughing, sneezing or vomiting.

It’s also possible to sustain subconjunctival hemorrhage as a result of trauma to the eye. Injury from a foreign object often causes it, and even rubbing repeatedly at the eye can be enough to rupture the blood vessels.

Diabetes can cause chronic subconjunctival hemorrhage, as can other conditions which affect the blood or its ability to clot, such as hemophilia. Use of blood thinning medications and aspirin can also make people more susceptible to subconjunctival hemorrhage.

How is a Subconjunctival Hemorrhage Treated?

Most individuals will not need any treatment for a subconjunctival hemorrhage because it will soon disappear on its own. If the eye is bothersome, artificial tears can be placed into the eye. Individuals should refrain from taking aspirin and those who are prescribed anticoagulant drugs, which hinder blood clot formation, should consult with their physician to find out if they should temporarily stop taking the medication.

In rare cases, an individual may have a weak capillary in their eye that causes repeated bleeding in the same spot. When this occurs, an ophthalmologist can perform a procedure using a laser to shut off the blood vessel.

Subconjunctival Hemorrhage Prevention

Since subconjunctival hemorrhage usually only occurs very occasionally and through everyday actions such as sneezing and coughing, it cannot always be prevented. However, for those with chronic, recurrent subconjunctival hemorrhage caused by an underlying medical condition or the use of blood-thinning medications, it may be helpful to discuss the issue with a doctor. Alternative treatments may be available, or there may be extra steps such individuals can take to reduce the frequency of subconjunctival hemorrhage.

In order to prevent subconjunctival hemorrhage when rubbing the eyes, be sure to rub only very gently. If you feel you have something stuck in your eye, try rinsing it out with clean water rather than repeatedly rubbing. Finally, to prevent subconjunctival hemorrhage caused by injury, take care to wear protective gear, such as goggles, when performing activities which could cause foreign objects or dirt to fly into the eye.

Last Reviewed:
October 09, 2016
Last Updated:
November 30, 2017