Your Questions Answered

By Dr Veerle Van Tricht

A sub-conjunctival haemorrhage occurs when a tiny blood vessel breaks just underneath the clear surface of your eye (conjunctiva). The conjunctiva can’t absorb blood very quickly, so the blood gets trapped. You may not even realize you have a sub-conjunctival haemorrhage until you look in the mirror and notice the white part of your eye is bright red.

It can happen without any obvious reason. Even a strong sneeze or cough can cause a blood vessel to break in the eye. You don’t need to treat it and although your symptoms may worry you, it is usually a harmless condition that disappears within two weeks or so.

Symptoms

The most obvious sign of a sub-conjunctival haemorrhage is a bright red patch on the white (sclera) of your eye.

You may experience a mild popping sensation in the eye prior to observing the redness.

Despite its bloody appearance, a sub-conjunctival haemorrhage should cause no change in your vision, no discharge from your eye and no pain. Your only discomfort may be a scratchy feeling on the surface of your eye.

Causes

The cause of a sub-conjunctival haemorrhage isn’t always known. The following actions may cause a small blood vessel to rupture in your eye:

• Violent coughing
• Powerful sneezing
• Straining
• Vomiting

In some cases, a sub-conjunctival haemorrhage may result from an eye injury, including:

• Roughly rubbing your eye
• Trauma, such as a foreign object injuring your eye

Risk factors

Risk factors for a sub-conjunctival haemorrhage include:

• Diabetes
• High blood pressure (hypertension)
• Certain blood-thinning medications, such as warfarin and aspirin
• Blood-clotting disorders 

Complications

Health complications from a sub-conjunctival haemorrhage are rare. If your condition is due to trauma, your doctor may evaluate your eye to ensure you don’t have other eye complications or injury.

Prevention

If the bleeding in your eye has a clearly identifiable cause, such as a bleeding disorder or blood-thinning medication, ask your doctor if you can take any steps to reduce the risk of a sub-conjunctival haemorrhage.

If you need to rub your eyes, rub gently. Rubbing too hard can cause minor trauma to your eyes, which may lead to a sub-conjunctival haemorrhage.

Diagnosis

Your doctor or ophthalmologist will generally diagnose a sub-conjunctival haemorrhage by looking at your eye. You are unlikely to need other tests.

If you have recurrent sub-conjunctival haemorrhages, your doctor may also:

• Ask you questions about your general health and symptoms
• Conduct an eye examination
• Take your blood pressure
• Obtain a routine blood test to make sure you don’t have a potentially serious bleeding disorder

Treatment

You may want to use eye drops, such as artificial tears, to soothe any scratchy feeling you have in your eye. Beyond that, the blood in your eye will absorb within about one to two weeks, and you will not require any treatment.

If you have any concerns regarding your sight, please don’t hesitate to contact me for advice.

Telephone: 01633 244023

Email: drv@drveerlevantricht.com