Subconjunctival Hemorrhage

Definition:  A subconjunctival hemorrhage occurs when a blood vessel of the white part of the eye (conjunctiva) breaks and bleeds, resulting in a reddened eye.   The condition is analogous to a bruise on the skin, where vessels have broken and caused a localized discoloration.

Cause:  Typically, no cause can be identified for subconjunctival hemorrhages. Sometimes older people are more prone to this condition due to aging changes in the small blood vessels of the conjunctiva, which make them more prone to bleed.  Straining or heavy lifting can sometimes cause this condition to occur.  If hemorrhages recur repeatedly over several months or longer, an underlying medical condition, such as high blood pressure, may be the cause.

Symptoms: A subconjunctival hemorrhage usually appears as new area of dark red coloration on the eye.  Often, the eye will be white next to the area of hemorrhage, with a fairly well defined border between the hemorrhagic area and the white, uninvolved area. Typically there is no discomfort, or only a mild feeling of irritation.  The vision almost never decreased from a subconjunctival hemorrhage.

Treatment:  No treatment is required for subconjunctival hemorrhage.  If mild irritation is present, artificial tears may help sooth the eye.  If hemorrhages occur frequently, a person should receive a medical evaluation to ensure they do not have high blood pressure or other, rare causes of bleeding. Patients are encouraged to pursue a consultation for proper diagnosis and treatment for any eye redness that is concerning or does not improve in short time.

Prognosis:  Like a bruise on the skin, a subconjunctival hemorrhage resolves with time.  It may take a few weeks to completely resolve, during which time the involved area may turn yellowish in color, just like a resolving bruise.