Subconjunctival hemorrhage 

Overview  

A subconjunctival hemorrhage is a mild condition characterized by a ruptured blood vessel that bleeds on the surface of the eye or conjunctiva. Since the conjunctiva cannot absorb blood quickly, blood becomes stuck. The blood causes the eye’s white to turn bright red.  

The conjunctiva is the transparent membrane that borders the inside of the eyelids and covers the white of the eye. It consists of many small blood vessels called capillaries, which can easily break. When a blood vessel breaks, blood can leak beneath the conjunctiva, causing a noticeable change in the appearance of the white part of your eye (sclera), which turns bright red. 

A subconjunctival hemorrhage does not affect the eyesight. It frequently happens with no evident damage to the eye. Even a severe sneeze or cough might cause a blood vessel in the eye to burst. Most cases of subconjunctival hemorrhage do not require treatment. They usually disappear on their own within a few weeks. 

Symptoms

A subconjunctival hemorrhage, characterized by a conspicuous red patch on the white of the eye, is readily observable but usually devoid of pain, swelling, or vision issues. Despite its bloody appearance, a subconjunctival hemorrhage is generally benign and does not impact vision, cause discharge, or induce significant pain. The only discomfort experienced may be a slight scratchy sensation on the eye’s surface. 

Causes  

Subconjunctival hemorrhages can occur without a clear reason. Some activities and medical situations might temporarily increase blood pressure in the veins. This sudden increase in pressure might cause blood vessels in your eyes to burst. 

Causes can include: 

• Straining, such as when coughing, sneezing, vomiting, or using the restroom. 
• Moving forward by lifting, pushing, or bending. 
• Rubbing the eye too hard. 
• Activities that involve lifting, pushing, or bending forward. 
• Trauma, such as an eye injury caused by a foreign object. 
• Using contact lenses. 
• Taking certain medications, including blood thinners and interferon, a cancer drug. 
• Having diabetes. 
• Having high blood pressure. 

Risk factors  

Several risk factors may increase the risk of developing a subconjunctival hemorrhage, such as:  

• Age: Individuals aged 65 and older are particularly susceptible to experiencing a subconjunctival hemorrhage. This risk is especially increased for those who have vascular conditions, such as high blood pressure and/or diabetes.   
• Wearing of contact lens: People who wear contact lens face an elevated risk of developing subconjunctival hemorrhages. Such conditions can induce dryness, friction, inflammation, and ultimately result in the rupture of blood vessels in the conjunctiva.  

• Medication: Taking certain blood–thinning medications, such as warfarin and aspirin, as well as having blood–clotting issues, can contribute to an increased risk of subconjunctival hemorrhage.  
• Surgery: Having undergone eye surgeries such as cataract surgery puts individuals at an elevated risk of developing subconjunctival hemorrhages.