Bilateral subconjunctival hemorrhage presents as a bright red patch on the white surface of one or both eyes. This condition, while visually alarming, is generally harmless. It rarely impacts vision, serving primarily as a cosmetic concern.
Recognizing Subconjunctival Hemorrhage
A subconjunctival hemorrhage appears as a vivid red patch on the sclera, the white part of the eye. This discoloration results from a tiny blood vessel breaking just beneath the conjunctiva, the clear, thin membrane that covers the white of the eye and the inside of the eyelids. The blood becomes trapped between the conjunctiva and the sclera, similar to how a bruise forms under the skin.
The conjunctiva is unable to absorb this blood quickly, leading to its visible accumulation. This trapped blood does not leak out of the eye, nor does it affect the pupil or iris. The condition is usually painless and does not cause discharge or changes in vision.
Causes of Subconjunctival Hemorrhage
Subconjunctival hemorrhage often results from a brief increase in pressure within the veins, causing tiny capillaries to rupture. These actions include forceful coughing, sneezing, vomiting, or straining during activities like bowel movements or heavy lifting. Even rubbing the eyes too vigorously or experiencing minor eye trauma can precipitate this condition.
While these common causes can affect one or both eyes, bilateral subconjunctival hemorrhage can sometimes suggest underlying systemic conditions. High blood pressure is a frequent systemic cause, as sustained elevated pressure can make blood vessels more fragile. Individuals taking anticoagulant medications, commonly known as blood thinners, are also more susceptible due to their reduced clotting ability. Less commonly, bilateral hemorrhages might indicate a blood clotting disorder, certain vascular diseases, or severe infections affecting the body’s vascular system.
When Medical Attention Is Needed
While often benign, certain circumstances accompanying a subconjunctival hemorrhage warrant prompt medical evaluation. Eye pain, any changes in vision like blurriness or double vision, or the presence of discharge from the eye require immediate attention. Sensitivity to light, a history of recent head or eye trauma, or recurrent hemorrhages also suggest the need for a doctor’s visit to rule out more serious issues.
If the individual is currently taking blood-thinning medication, a medical consultation is advisable, as this could indicate an increased risk of bleeding elsewhere in the body. If the subconjunctival hemorrhage is bilateral and lacks a clear, benign cause such as a cough or sneeze, a medical evaluation is recommended to investigate potential underlying systemic conditions like uncontrolled high blood pressure or a blood clotting disorder. Your healthcare provider may conduct a physical exam, including an eye examination, and may also measure blood pressure.
Resolution and Care
Subconjunctival hemorrhages resolve spontaneously without specific medical treatment, much like a bruise fading on the skin. The healing process involves the eye gradually reabsorbing the trapped blood. As the blood dissipates, the bright red patch may change color, often progressing to shades of yellow or green before completely disappearing.
Most subconjunctival hemorrhages clear completely within one to three weeks, depending on their initial size. During this healing period, it is advisable to avoid rubbing the affected eye, as this can cause further irritation or injury. Unless prescribed by a healthcare professional, eye drops are unnecessary. Vision remains unaffected throughout this process, and the condition is rarely indicative of a serious underlying eye problem.