The conjunctiva is the clear membrane covering
the white part of the eye (sclera). It protects
and lubricates the eyeball and also allows the
eye to turn easily.
The conjunctiva covers many small, rather
fragile blood vessels. Rupture of one of these
small vessels or capillaries results in a
This appears as a
sharply outlined bright red spot on the sclera.
This rapid-onset appearance of "blood" on the
eye is one of the most common reasons patients
present to the eye doctor with dramatic concern.
A subconjunctival hemorrhage
is a sudden filling or partial filling of the
whites of the eye with blood. It usually follows
a trauma to the eye. Other causes include
coughing, sneezing, vomiting, strangulation,
constipation, and seizure. The most common cause
is simple rubbing of the eyes. This mechanically
distorts the conjunctiva, bursting open one of
the small blood vessels.
Raising the pressure inside the conjunctival
veins also can cause a hemorrhage. This can
occur with lifting heavy objects. The use of
alcohol or certain drugs that thin the blood
(such as anticoagulants, aspirin, and ibuprofen)
can contribute to a subconjunctival hemorrhage.
Most of the time, an obvious cause is not found.
These can just happen. Only rarely is it ever
associated with high blood pressure or other
bleeding problem. Usually, this is unilateral,
but could present bilaterally.
Most of the time there are no symptoms, however
some patients complain of a sharp pain when it
begins. Many people become alarmed by the sudden
onset of this common problem. However, it is not
associated with any diseases which will cause a
loss of vision. The hemorrhage tends to fade
over two to three weeks and clears
last in the area next to colored part of the eye
No treatment is needed in this condition! What
may be helpful would be the initial use of cold
packs during the first day or two to help
coagulate the blood, followed by the use of hot
packs to aid in reabsorption of loose blood.
Happily, subconjunctival hemorrhages will go
away and only be a cosmetic problem for a few
days. If concern continues, a reevaluation in a
week is OK. For more than two recurrences within
1 year, it is suggested a full medical workup by
your physician be done.