The appearance of a “broken blood vessel in the eye” is a common, often alarming symptom. The close proximity of the sinuses to the eyes prompts the question of whether pressure from congestion can cause this ocular bleeding. Direct, steady sinus pressure alone is unlikely to be the sole cause. However, the forceful actions that frequently accompany severe sinus issues are a recognized mechanism for this type of vessel rupture, involving rapid pressure changes rather than chronic inflammation.
Understanding Subconjunctival Hemorrhage
A broken blood vessel in the eye is medically termed a subconjunctival hemorrhage (SCH). This is an extravasation of blood beneath the conjunctiva, the thin, clear membrane covering the white part of the eye (sclera). The conjunctiva contains numerous tiny, fragile capillaries that can break easily, trapping blood between the membrane and the sclera.
The result is a bright red, sharply demarcated patch on the white of the eye that often looks worse than it is. Since the blood is contained beneath the conjunctiva, it does not leak out or affect the cornea. SCH is typically painless, does not cause discharge, and rarely impacts vision, which helps distinguish it from more serious eye conditions. The condition is generally benign and resolves on its own without treatment, similar to a bruise on the skin.
The Mechanics of Sinus Pressure and Ocular Circulation
Direct sinus pressure from inflammation, such as in a sinus infection, is not typically sufficient to cause a subconjunctival hemorrhage alone. While inflammation can cause discomfort, swelling, and a feeling of pressure behind the eyes, this steady pressure does not usually rupture the conjunctival capillaries. However, the forceful actions people take when dealing with severe sinus symptoms are a common trigger for vessel rupture.
A sudden, intense increase in pressure in the head and upper chest, known as the Valsalva maneuver, often leads to SCH in the context of sinus issues. Actions like forceful sneezing, aggressive nose-blowing, or a hard, hacking cough rapidly increase intrathoracic and intra-abdominal pressure. This pressure rise is quickly transmitted to the venous system of the head, causing a temporary spike in pressure within the delicate conjunctival blood vessels, which can cause them to burst.
The mechanism is the acute, momentary spike in venous pressure caused by straining, not the chronic pressure of the sinus infection itself. While the sinus issue provides the reason for the straining action, the secondary action directly forces the vessel to break. The temporary nature of this pressure surge explains why the rupture is confined to the fragile conjunctival capillaries and is not indicative of a deeper ocular problem.
Common Triggers of Ocular Vessel Rupture
The conjunctival capillaries are sensitive to any sudden, intense increase in cephalic venous pressure. Beyond the forceful actions associated with sinus trouble, one of the most frequent non-sinus related causes is straining during heavy lifting or extreme physical exertion. The effort of bearing down during weight training or other intense activities mimics the pressure changes of a Valsalva maneuver.
Severe episodes of vomiting, straining due to constipation, or crying forcefully are also recognized triggers for this type of eye bleed. Physical trauma to the eye or surrounding area, including aggressive eye rubbing, can directly damage the blood vessels and lead to hemorrhage.
Certain systemic conditions and medications also increase the risk of a rupture. These include high blood pressure (hypertension) and blood-thinning medications like aspirin or warfarin. People with vascular or blood-clotting disorders may experience spontaneous or recurrent hemorrhages more frequently.
When to Seek Medical Attention
Most subconjunctival hemorrhages are harmless and begin to fade within a few days, fully resolving within one to two weeks as the body absorbs the blood. The red patch may change color, sometimes turning yellowish as it clears, similar to a fading bruise. No specific treatment is necessary, though artificial tears may be used if the eye feels mildly irritated.
While the condition is usually benign, certain signs warrant immediate medical consultation to rule out a more serious underlying issue. Seek attention if the hemorrhage is accompanied by eye pain, discharge, or any changes in vision. Recurrent episodes, especially those without an obvious cause like straining, should be evaluated for systemic problems such as undiagnosed high blood pressure or a bleeding disorder. If the bleeding occurred following a significant head or eye injury, a medical professional must examine the eye to ensure there is no deeper damage.