A red eye can be alarming, often leading people to wonder if the cause is an infection or a burst blood vessel. Both Pink Eye (conjunctivitis) and a Broken Blood Vessel (subconjunctival hemorrhage) cause the white part of the eye to turn red. While they may appear similar, they are fundamentally different conditions with distinct causes and approaches to management. Understanding these differences is the first step toward proper eye care.
How Redness Appears in Each Condition
The appearance of the redness is the most immediate way to distinguish between these two conditions. A broken blood vessel is caused by the rupture of a tiny blood vessel beneath the conjunctiva, the clear membrane covering the white of the eye. This results in a sharply defined, bright red patch of blood trapped between the conjunctiva and the underlying sclera, looking uniform and solid like a spot of spilled paint. Conversely, pink eye redness is a generalized, diffuse pink or reddish appearance caused by inflammation and dilation of surface blood vessels. The eye takes on a bloodshot look with fine red lines visible across the entire surface, and often spreads to the other eye, whereas a subconjunctival hemorrhage typically affects only one eye.
Key Symptoms That Differentiate the Cause
The symptoms accompanying the redness are the most reliable way to differentiate between a bleed and an infection. A broken blood vessel is typically a silent event, meaning it is usually painless and causes no changes in vision. Aside from the alarming appearance, the only physical sensation may be a mild feeling of scratchiness or fullness on the surface of the eye. This condition is visually dramatic but functionally insignificant.
Pink eye, however, is characterized by distinct symptoms beyond just the redness. Patients often report an uncomfortable, gritty sensation, often described as feeling like sand is in the eye. Significant discharge is a hallmark symptom; this may be watery and clear with viral conjunctivitis, or thick and pus-like with bacterial infections. Itching, light sensitivity, and excessive tearing are common accompanying features of the inflammatory process.
When to Seek Professional Eye Care
While a subconjunctival hemorrhage usually resolves on its own within one to two weeks, and many cases of pink eye are self-limiting, certain signs warrant prompt medical evaluation. Any sudden change in vision, such as blurriness or loss of sight, requires immediate attention. Severe eye pain or an intense foreign body sensation that prevents the eye from opening should also prompt an urgent visit to an eye care professional. Other concerning symptoms include redness accompanied by a severe headache, nausea, or vomiting. Additionally, if symptoms persist for more than a week, or if you notice a thick, yellow, or green discharge, a doctor’s examination is necessary, as are recurrent broken blood vessels without trauma, which may indicate high blood pressure or a bleeding disorder.