Subconjunctival Hemorrhage

A subconjunctival hemorrhage occurs when a tiny blood vessel breaks just beneath the clear surface of the eye, called the conjunctiva. This can cause a speck of redness on the white of the eye or a larger area of visible blood.

While a subconjunctival hemorrhage can look scary, it is usually harmless and will resolve on its own without treatment.

In this article, you'll learn about the causes and symptoms of a subconjunctival hemorrhage. It will also describe the treatment options and when it is time to see a healthcare provider.

Symptoms of a Subconjunctival Hemorrhage

The sclera is the white part of your eye that is covered by a thin, clear tissue called the conjunctiva. The conjunctiva also lines the inside of your eyelid and houses a network of tiny blood vessels, called capillaries.

Capillaries are fragile and can easily break. The burst vessel will then leak blood into the space between the conjunctiva and sclera.

A subconjunctival hemorrhage is usually painless, although some people may experience a scratchy sensation in the eye.

If the leakage of blood is small, a subconjunctival hemorrhage may only cause a small area of redness or even a tiny red speck.

But, if the leakage is significant, the entire white of the eye may look red. In some cases, the affected tissues may bulge visibly outward.

Causes of a Subconjunctival Hemorrhage

A subconjunctival hemorrhage can be caused by a mechanical injury to the eye, certain medical conditions, or sudden, forceful changes to eye blood pressure.

Some of the possible causes of a subconjunctival hemorrhage include:

• Eye trauma
• Forceful coughing or sneezing
• Violent vomiting
• Excessive eye rubbing
• Heavy lifting
• Straining due to constipation
• Severe high blood pressure
• Extreme changes in atmospheric pressure
• Certain conjunctival eye infections
• Use of blood thinners like warfarin
• Bleeding disorders, like hemophilia
• Laser eye surgery

A newborn baby can also have a subconjunctival hemorrhage. This is caused by pressure changes as the baby passes through the birth canal during childbirth.

A subconjunctival hemorrhage may also be a warning sign for a severe underlying condition like diabetes, leukemia, or sickle cell disease.

Diagnosis

A subconjunctival hemorrhage can be diagnosed with a visual examination of the eye. In addition to the eye exam, the optometrist or an ophthalmologist will take a complete medical history, including any drugs you may be taking. A blood pressure reading should also be taken.

Other tests may be ordered, if needed, including:

• Slit-lamp exam: A routine, non-invasive procedure in which bright light is directed into the eye to check for injury or disease
• Ocular tonometry; A non-invasive test used to measure the pressure inside your eyes
• Blood tests; Including tests like factor VIII and partial thromboplastin time (PTT) that can help check for bleeding disorders

How Subconjunctival Hemorrhage Is Treated

A subconjunctival hemorrhage doesn't usually require treatment. Most will clear on their own within two weeks (although a warm compress to the eye may speed healing).

Any irritation or scratchiness can usually be relieved with over-the-counter artificial tears.

When to Call a Healthcare Provider

There may be times when a subconjunctival hemorrhage is a sign of something more serious. See a healthcare provider if you experience any of the following:

• A subconjunctival hemorrhage lasting more than three weeks
• A subconjunctival hemorrhage with eye pain
• Vision loss, including blurring and light sensitivity
• Recurring subconjunctival hemorrhages

Summary

A subconjunctival hemorrhage is bleeding in the white of the eye caused by a broken blood vessel. It is usually harmless, causing an area of blood-red discoloration that usually resolves on its own within two weeks.

Causes of subconjunctival hemorrhages include eye injury, severe high blood pressure, forceful sneezing or coughing, eye infections, certain medications, or bleeding disorders.

A Word From Verywell

Even though the appearance of blood in your eye can be disturbing, it's usually no cause for alarm, especially if you don't have any pain or vision changes.

However, if you experience a subconjunctival hemorrhage more than twice a year, you should get a full checkup to see if there are any medical condtion contributing to the recurrence.