A sudden, bright red patch appearing on the white of your eye can be alarming, but this common occurrence, known as a subconjunctival hemorrhage (SCH), is usually harmless. It results from a tiny blood vessel breaking beneath the clear membrane covering the eye, much like a bruise develops under the skin. While the appearance can be dramatic, SCH typically resolves without intervention and does not affect your vision. Understanding the nature of this surface bleeding and knowing when to seek professional medical advice provides the best approach to managing this condition.
Understanding the Types of Eye Bleeding
A subconjunctival hemorrhage occurs when a delicate blood vessel in the conjunctiva ruptures, causing blood to pool between the conjunctiva and the underlying white layer of the eye, the sclera. Because the blood is trapped in this confined space, it forms a vivid, sharply defined red spot on the eye’s surface. The condition is nearly always painless and does not cause changes to vision, which helps distinguish it from more serious types of ocular bleeding.
Internal bleeding within the eye, known as intraocular hemorrhage, presents a far more serious concern. A hyphema involves blood collecting in the anterior chamber (the space between the cornea and the iris), often resulting from trauma. This blood is typically accompanied by pain, blurred vision, or light sensitivity. A vitreous hemorrhage involves bleeding into the vitreous body, which can cause floaters or sudden vision loss. These internal bleeds require immediate evaluation by an eye care specialist due to their potential to cause permanent vision problems.
Common Triggers for Surface Eye Bleeding
The cause of a subconjunctival hemorrhage is often related to a sudden, temporary increase in venous pressure that strains the small, fragile capillaries. These pressure spikes can be caused by physical actions that involve forceful exhalation or muscle straining. Common triggers include violent sneezing, coughing fits, or episodes of vomiting.
Other mechanical actions, such as aggressive eye rubbing, minor direct trauma, or straining during a bowel movement, can also cause rupture. Certain underlying systemic factors or medications increase the likelihood of a vessel breaking spontaneously. These include high blood pressure (hypertension), diabetes, and the use of blood-thinning medications, such as aspirin or prescription anticoagulants.
Self-Care and Resolution Timeline
The most important aspect of “fixing” a subconjunctival hemorrhage is recognizing that the body handles the resolution naturally, much like a bruise. No specific medical treatment, such as eye drops or medication, is required to accelerate the absorption of the pooled blood, as drops will not help the blood trapped beneath the conjunctiva reabsorb any faster.
The hemorrhage clears up as the body slowly breaks down and absorbs the blood cells. The timeline for resolution is generally between ten days and two weeks, though larger hemorrhages may take longer to fully disappear. As the blood clears, the bright red patch will fade and may change color, sometimes appearing yellowish or greenish before resolving. To manage any mild irritation or scratchiness, you can use over-the-counter artificial tears for lubrication. Avoid rubbing the eye, as this can cause further irritation or potentially lead to another rupture.
Recognizing Serious Symptoms and When to Consult a Doctor
While a subconjunctival hemorrhage is typically harmless, certain accompanying symptoms suggest a more severe underlying issue that requires immediate professional evaluation. The presence of pain, especially sharp or persistent pain, is a major warning sign that the bleeding may not be confined to the surface.
Any sudden changes to your vision, such as blurriness, double vision, or loss of sight, must be evaluated urgently by an eye doctor. Other concerning symptoms include persistent headache, discharge from the eye, or if the bleeding appears to involve the iris or the pupil. If the bleeding resulted from a significant blow or injury, or if the hemorrhage does not begin to clear up within the expected two-week timeline, a consultation is necessary to rule out deeper injury.