Subconjunctival Hemorrhage

The conjunctiva is the white of the eye that contains many tiny blood vessels. If these blood vessels break, it can cause bleeding in the eye or a condition known as subconjunctival hemorrhage, which is not severe and resolves on its own without affecting vision.

Symptoms

Apart from the red spots in the eye, subconjunctival hemorrhages do not cause any other side effects. There is no pain, swelling, or any impact on vision. In some cases, the patient may feel a slight irritation in the affected eye, but there is no discharge or other symptoms.

When to see a doctor

• The red spot in your eye does not improve after two weeks. 
• You have blood in your eyes after an injury, rubbing your eyes, or removing contact lenses.
• You have pain and vision problems.
• Your subconjunctival hemorrhage recurs.

Causes

Activities or health problems that raise blood pressure can cause the tiny blood vessels in your eyes to break.

• Coughing, sneezing, vomiting, straining during bowel movement. 
• Having an eye or head injury or eye infection. 
• Rubbing your eye harshly or frequently.
• Wearing contact lenses.
• Taking some medications, such as blood thinners or interferon

Other underlying health conditions that can be the causes of subconjunctival hemorrhages are diabetes, hypertension, and bleeding disorders.

Risk factors

• Old age: People 65 and above are at risk of subconjunctival hemorrhage. 
• Health conditions: You are at higher risk of subconjunctival hemorrhages if you have diabetes or hypertension. 
• Contact lens: Wearing contact lenses can lead to inflammation and broken blood vessels.  
• Eye surgery: Cataract surgery increases the risk of subconjunctival hemorrhage.

Complications

Subconjunctival hemorrhages are not dangerous. In rare cases, it can be a sign of a serious underlying health condition such as a bleeding disorder, severe eye trauma, vascular disease, or severe asthma.

Diagnosis

• History taking and eye examination.

  The physician will inquire about your medical history and symptoms, perform an eye examination, and may also measure blood pressure. Typically, no further tests are necessary unless subconjunctival hemorrhages recur.

• Blood tests 

  If the physician suspects the patient has an abnormal bleeding disorder, they may order additional blood tests.
  Treatment

If there is irritation, the patient can alleviate the symptoms using lubricating eye drops or artificial tears. Typically, the symptoms can resolve by themselves within 1-2 weeks.

Prevention

• Avoid rubbing your eyes. 
• If your condition is due to a bleeding disorder or blood thinners, consult your doctor for further treatment of the underlying health problems.

Preparation for the doctor’s appointment

Before seeing a doctor, you should list all the symptoms you have been experiencing, your recent life changes, the medications, and dietary supplements you have been taking, and any questions you would like to ask your doctor during the appointment.

Examples of questions that you can prepare:

• What causes subconjunctival hemorrhage? 
• Can it recur?
• Do I have to undergo any tests?
• What are the treatments for this condition?

Your doctor may ask several questions, including:

• When did the symptoms start? 
• Do you have any symptoms?

Doctor's note

Usually, subconjunctival hemorrhage is not dangerous and tends to resolve without treatment within 1-2 weeks. If it recurs or there is pain, it is advisable to consult a physician for a thorough examination to determine the underlying causes.