A subconjunctival hemorrhage (SCH) is a common eye condition resulting in a bright red patch on the white part of the eye. This redness occurs when a tiny blood vessel breaks just beneath the conjunctiva, the clear membrane covering the eye’s surface. Although the appearance can be dramatic, an SCH is essentially a bruise on the eye. It is typically harmless and resolves on its own without intervention. Most people are primarily concerned with understanding the natural healing process and how long the red spot will take to disappear.
What Causes a Subconjunctival Hemorrhage
A subconjunctival hemorrhage is caused by the rupture of small capillaries lying just under the conjunctiva. Since these vessels are delicate, minor physical stresses can cause them to break. The most frequent triggers are actions that cause a sudden, temporary increase in venous pressure in the head and neck.
These triggers include forceful actions like severe coughing, sneezing, or vomiting. Straining during heavy lifting, during a bowel movement, or during childbirth can also cause the vessels to rupture. Minor trauma, such as aggressive eye rubbing, is another common cause. Underlying conditions like high blood pressure, diabetes, or the use of blood-thinning medications can increase vessel fragility, making an SCH more likely.
The Standard Recovery Timeline
The healing process typically takes between one and three weeks, with most cases resolving within 7 to 14 days. The duration depends primarily on the initial size of the hemorrhage. The blood does not flow out of the eye; instead, it is slowly reabsorbed by the body, similar to how a bruise on the skin fades.
The color progression indicates healing as the body breaks down the trapped blood. The spot starts as a bright red and gradually changes color. As healing progresses, the red area often fades to a darker red, then takes on a yellowish or brownish tint before disappearing. This discoloration confirms that the body is clearing the blood from the subconjunctival space.
The eye should feel normal during recovery, with no change in vision or significant pain. Larger hemorrhages or those in individuals with blood clotting disorders may require a slightly longer period for full resolution. If the blood spot has not begun to fade or clear after two weeks, a follow-up consultation is recommended.
Home Management During Healing
Since the condition is self-limiting, no medication is required to dissolve the blood or speed up healing. Home management focuses on comfort and avoiding actions that might exacerbate the condition or cause recurrence. If the eye feels mildly irritated or dry, over-the-counter artificial tears may be used for comfort.
It is important to refrain from rubbing the eye, as this can cause further damage. Individuals who wear contact lenses should avoid using them until the eye feels comfortable and the redness has faded. Additionally, pain relievers containing aspirin should be avoided, as they can increase the risk of bleeding.
Signs It Might Be More Serious
While most subconjunctival hemorrhages are benign, certain accompanying symptoms suggest a more serious underlying issue. The presence of severe eye pain, blurred vision, or a noticeable decrease in vision requires immediate medical evaluation. These symptoms indicate the problem may not be confined to the surface of the eye.
Other red flags include double vision, a persistent headache, or sensitivity to light (photophobia). If the hemorrhage followed a significant blow or injury to the head or eye, medical attention is necessary to rule out deeper trauma. Recurring hemorrhages without an apparent cause may signal an underlying medical condition, such as uncontrolled high blood pressure or a blood clotting disorder.