Subconjunctival haemorrhage (bleeding in the eye)
Subconjunctival haemorrhage overview
The conjunctiva is the thin, moist, transparent membrane that covers the white part of the eye (called the sclera) and the inside of the eyelids. The conjunctiva is the outermost protective coating of the eyeball.
The conjunctiva contains nerves and many small blood vessels. These blood vessels are usually barely visible but become larger and more visible if the eye is inflamed. These blood vessels are somewhat fragile and their walls may break easily, resulting in a subconjunctival haemorrhage (bleeding under the conjunctiva). A subconjunctival haemorrhage appears as a bright red or dark red patch on the sclera.
Picture of subconjunctival haemorrhage.
Subconjunctival haemorrhage causes
Most subconjunctival haemorrhages are spontaneous without an obvious cause for this bleeding from the conjunctival vessels. Often, a person may discover a subconjunctival haemorrhage on waking up and looking in the mirror. Most spontaneous subconjunctival haemorrhages are noticed first by another person seeing a red spot on your eye.
The following can occasionally result in a spontaneous subconjunctival haemorrhage:
- 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