A subconjunctival hemorrhage, commonly called a “popped blood vessel,” is the sudden appearance of a bright red spot on the white of the eye. Although often alarming, this condition is typically harmless. Contact lens wearers immediately need to know if they can safely continue using their lenses or if they must switch to glasses.
Understanding the Subconjunctival Hemorrhage
A subconjunctival hemorrhage occurs when a tiny blood vessel breaks beneath the conjunctiva, the thin, clear membrane covering the white part of the eye. The broken capillary releases blood that becomes trapped between the conjunctiva and the underlying sclera. This results in a flat, bright red patch that resembles a bruise, but the condition is usually benign and does not affect vision or cause pain.
The conjunctiva contains many delicate, minute blood vessels that are prone to rupture from sudden increases in pressure. Common causes include violent sneezing, strenuous coughing, vomiting, or straining during a bowel movement. Even minor trauma, such as aggressive eye rubbing or the act of putting in or taking out contact lenses, can sometimes trigger a hemorrhage.
The condition is often noticed only when a person looks in the mirror because it typically presents without any symptoms other than the conspicuous redness. In many instances, the specific cause remains unknown. However, certain factors like high blood pressure, taking blood-thinning medications, and diabetes can increase the risk.
Why Contact Lenses Must Be Avoided
Contact lenses must be avoided immediately and completely until the condition resolves; switching to glasses is the safest and most recommended action. Wearing a contact lens over a compromised eye surface introduces several risks that can transform this benign condition into a serious complication.
One significant concern is the increased risk of infection, such as microbial keratitis. The contact lens acts as a physical barrier, trapping bacteria and other microorganisms against the vulnerable surface of the eye. This significantly raises the potential for a severe infection that could affect vision.
The lens itself causes mechanical friction over the area where the blood is being absorbed. This constant rubbing slows down the natural healing process and can cause irritation or discomfort. The lens essentially acts as a foreign body that aggravates the affected tissue, delaying the natural reabsorption of the blood.
The presence of a contact lens interferes with the normal flow of oxygen to the cornea, a process known as hypoxia. Since the cornea receives its oxygen directly from the air, a lens already reduces this supply. Wearing a lens while the eye is recovering exacerbates this oxygen deprivation, further compromising the health of the ocular surface.
Timeline for Healing and Resuming Contact Lens Wear
A subconjunctival hemorrhage is self-limiting, meaning it will resolve on its own without requiring any specific medical treatment. The body naturally reabsorbs the blood, much like a bruise fades on the skin. This natural process typically takes between one and two weeks, though larger hemorrhages may take slightly longer, up to three weeks.
As the blood is broken down by the body, the color of the patch will gradually change. The bright red spot will often transition to a yellowish or greenish tint before completely disappearing. This change in color is a normal sign of the healing process and indicates the blood is being cleared from the area.
Safely resuming contact lens wear requires complete resolution of the hemorrhage. You should only reintroduce your lenses once the redness has entirely vanished and the eye looks completely normal. This ensures the ocular surface is fully healed and the risk of trapping bacteria or causing further irritation is minimized.
It is important to watch for certain red flags that signal the need for immediate medical attention, even if the hemorrhage appears to be fading. If you experience any pain, a change in your vision, discharge from the eye, or increased sensitivity to light, you must contact an eye care professional right away. These symptoms are not typical of a simple subconjunctival hemorrhage and could indicate a more serious underlying problem or a developing infection.
Recurrence of subconjunctival hemorrhages or if the bleeding resulted from a direct injury to the eye also warrants a consultation with a doctor. A healthcare professional may need to perform a thorough eye examination, check blood pressure, and potentially order blood tests to rule out any underlying systemic conditions, such as a bleeding disorder or uncontrolled hypertension.