Subconjunctival Hemorrhage


Sub = below or underneath

Conjunctiva = clear tissue over the white of the eye

Hemorrhage = blood

Subconjunctival Hemorrhage means: Blood under the conjunctiva.

Symptoms of subconjunctival hemorrhage are usually limited to the sudden appearance of blood, or a bright red spot, covering the white of the eye. This is usually noticed by surprise when looking in the mirror or by someone looking at you. These hemorrhages, or bleeds, are painless and self-limiting. This means the blood will stay in this area and not cause other problems, such as vision loss. Subconjunctival hemorrhages can vary in presentations from a very small spot of red, to completely covering the white of the eye. Some may even be a dark red color and appear to “bulge” from the eye surface.

Causes of subconjunctival hemorrhages include:

Idiopathic: (no particular reason) or spontaneous. This is the most common cause of subconjunctival hemorrhages.

Valsalva maneuvers: This includes any activity or action that cause you to hold your breath and bear down, such as lifting a heavy item, being constipated, violent coughing or sneezing.

Trauma/Injury: If the eye experiences an injury it is likely to break a blood vessel or group of blood vessels.

Diabetes: Diabetic tend to have weaker blood vessel walls, which break easier.

High Blood Pressure or Hypertension: An increase in pressure or volume of blood within a blood vessel can cause the vessel wall to break.

Side effect of blood-thinning medications: Aspirin, warfarin/coumadin, and other anti-coagulant or anti platelet medications can cause subconjunctival hemorrhages.

Bleeding Disorders: Although this is possible, it is extremely rare. It is highly unlikely that a subconjunctival hemorrhage will be the first symptom of a bleeding disorder.

Treatment is usually limited to patient education and reassurance. Uncontrolled hypertension or diabetes needs to be treated by the patients primary care provider. Blood tests can be ordered to rule out bleeding disorders if a patient has several hemorrhages in a short period of time. In most cases, subconjunctival hemorrhages resolve on their own, in 1 to 2 weeks.

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