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Subconjunctival haemorrhage (bleeding in the eye)

Subconjunctival haemorrhage is bleeding in the whites of the eyes caused by burst blood vessels.

A subconjunctival haemorrhage appears as a bright red or dark red patch in the eye.

 

Picture of subconjunctival haemorrhage.

Subconjunctival haemorrhage causes

Often there is no obvious cause for bleeding in the eye, with a person noticing it when the look in the mirror or someone else notices it.

The following can occasionally result in a spontaneous subconjunctival haemorrhage:

  • Sneezing
  • Coughing
  • Straining/vomiting
  • Eye rubbing
  • Trauma (injury)
  • High blood pressure
  • Bleeding disorder
  • A medical disorder causing bleeding or inhibiting normal clotting

Subconjunctival haemorrhage can also be non-spontaneous and result from a severe eye infection, trauma to the head or eye or after eye or eyelid surgery.

Subconjunctival haemorrhage symptoms

Most of the time, there are no symptoms associated with a subconjunctival haemorrhage other than seeing blood over the white part of the eye.

  • Very rarely do people experience any pain when the haemorrhage begins. When the bleeding first occurs, you may experience a sense of fullness in the eye or under the lid. As the haemorrhage resolves, some people may experience very mild irritation of the eye or merely a sense of awareness of the eye.
  • The haemorrhage itself is an obvious, sharply outlined bright red area overlying the sclera. The entire white part of the eye may occasionally be covered by blood.
  • In a spontaneous subconjunctival haemorrhage, no blood will exit from the eye. If you blot the eye with a tissue, there should be no blood on the tissue.
  • The haemorrhage will appear larger within the first 24 hours after its onset and then will slowly diminish in size as the blood is absorbed.

When to seek medical care

It would be wise to see an ophthalmologist (a medical doctor who specialises in eye care and surgery) if the subconjunctival haemorrhage does not get better within two weeks or if you have had multiple subconjunctival haemorrhages.

Also, seek medical advice if you have a haemorrhage in both eyes at the same time or if the subconjunctival haemorrhage coincides with other symptoms of bleeding including easy bruising, bleeding gums or both.

Seek urgent medical advice immediately if you have a subconjunctival haemorrhage and you have:

  • Pain associated with the haemorrhage
  • Changes in vision (for example, blurry vision, double vision, difficulty seeing)
  • History of a bleeding disorder
  • History of high blood pressure
  • Injury from trauma to the eye

Questions to ask the doctor

  • Is there any sign of damage to the eye?
  • Will I develop any scarring or permanent vision loss from this subconjunctival haemorrhage?
  • What causes a subconjunctival haemorrhage?
  • How can I prevent a subconjunctival haemorrhage?

Examinations and tests

The doctor will take a concise history of the events prior to the subconjunctival haemorrhage and perform an examination. Your blood pressure may also be checked.

If trauma was the cause, a more thorough examination using a slit lamp (a special microscope for examining the eye) will usually be performed.

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