Subconjunctival Hemorrhage

Overview

What is subconjunctival hemorrhage?

Subconjunctival hemorrhage is the term for a broken blood vessel on the surface of the eye. The clear membrane that lines the inside of the eyelid and covers the white of the eye is called the conjunctiva. It has many very small blood vessels that break easily. When a break happens, blood can leak under the conjunctiva. When this happens, the blood causes part of the white of your eye to turn bright red.

The red spots caused by subconjunctival hemorrhage can look scary. But most cases do not cause any symptoms or need treatment. It is most common in older people, but it can happen at any age.

Symptoms and Causes

What causes a subconjunctival hemorrhage?

Most cases of subconjunctival hemorrhage have no known cause. Some events and conditions can cause blood vessels on the eye to break. These include:

  • Straining (during coughing, sneezing, vomiting, or while using the toilet)
  • Injury to the head or eye, including infection
  • Rubbing the eye too hard
  • Wearing contact lenses
  • Taking medications, including blood thinners and a cancer drug called interferon

What are the symptoms of subconjunctival hemorrhage?

Other than the red spot, there are no symptoms associated with subconjunctival hemorrhage. It does not cause pain or swelling, and it does not affect your vision. Most people who have so-called “red eye” do not even know it until they look in a mirror or someone tells them.

Diagnosis and Tests

How is subconjunctival hemorrhage diagnosed?

A doctor can diagnose subconjunctival hemorrhage by looking at the eye. The condition does not have any other identifying features.

Management and Treatment

How is subconjunctival hemorrhage treated?

Subconjunctival hemorrhage doesn’t require treatment. Artificial tears (eye drops) can help relieve eye irritation if it occurs. Most broken blood vessels heal within 2 weeks. Larger spots may take longer to go away. As the blood clears up, the color of the area may change, like a fading bruise.

Contact your doctor if pain accompanies the eye redness. This could be a sign of other conditions that are more serious, such as a hyphema (collection of blood in front of the colored part of the eye).

If broken blood vessels appear in your eyes often, your doctor may want you to undergo tests to try to identify an underlying cause. Sometimes, disorders related to blood clotting such as hemophilia or von Willebrand disease, make subconjunctival hemorrhage more likely.

Prevention

Can subconjunctival hemorrhage be prevented?

If you have risk factors for subconjunctival hemorrhage, you can take steps to prevent broken blood vessels, including:

  • Keeping your contact lenses clean
  • Wearing protective eyewear during sports or activities that involve flying debris
  • Checking with your doctor if you have a bleeding disorder

Last reviewed by a Cleveland Clinic medical professional on 02/20/2018.

References

  • American Academy of Ophthalmology. Accessed 2/20/2018. What is a Subconjunctival Hemorrhage? (https://www.aao.org/eye-health/diseases/what-is-subconjunctival-hemorrhage)
  • Tarlan B, Kiratli H. Subconjunctival hemorrhage: risk factors and potential indicators. Clin Ophthalmol. 2013;7:1163-70.
  • Leibowitz HM. The red eye. N Engl J Med. 2000;343(5):345-51.

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