A sudden, vivid red spot appearing on the white of the eye can be alarming, often leading people to believe they have suffered a serious injury. This appearance results from a small blood vessel rupturing just beneath the surface. Understanding the cause, from simple physical actions to underlying health issues, is the first step toward addressing the concern.
Defining the Condition
The medical term for a burst blood vessel in the eye is subconjunctival hemorrhage. This condition involves the rupture of minute, delicate blood vessels located in the conjunctiva. The conjunctiva is the thin, clear membrane covering the white part of the eye (sclera).
When a vessel breaks, the blood becomes trapped between the transparent conjunctiva and the opaque sclera, pooling into a sharply defined, bright red patch. A subconjunctival hemorrhage typically causes no pain, discharge, or change in visual acuity. Since the blood is confined to the surface layers, the condition is generally a benign, cosmetic issue rather than a threat to vision.
Acute Triggers
The most common immediate causes of a burst vessel are actions that produce a sudden spike in pressure within the body’s chest or abdominal cavities. This rapid increase temporarily overwhelms the walls of the small, fragile episcleral blood vessels. Forceful actions like severe coughing fits, violent sneezing, or repeated vomiting can create the internal stress necessary to cause a rupture.
Other forms of straining also elevate this pressure dramatically. These include heavy lifting, bearing down during a difficult bowel movement, or intense physical exertion. Direct trauma to the eye area, even minor actions like aggressive eye rubbing, can also damage the superficial vessels and lead to localized bleeding. In these instances, the mechanism is purely mechanical, causing the vessel to fail under sudden stress.
Underlying Medical Risk Factors
While acute straining can trigger a hemorrhage, certain systemic health conditions and medications can predispose an individual to vessel rupture, even with minimal provocation.
Systemic Conditions
Uncontrolled hypertension, or high blood pressure, is a significant risk factor because it exerts constant, excessive force against all blood vessel walls. This chronic pressure weakens vascular integrity, making the conjunctival vessels more susceptible to breaking from a minor pressure surge. Diabetes mellitus is another condition that compromises the health of small blood vessels throughout the body. High blood sugar levels damage the capillary walls, leading to increased fragility and a higher likelihood of rupture.
Medications and Clotting Disorders
The use of certain medications designed to prevent blood clots significantly increases the risk and severity of a subconjunctival hemorrhage. These include antiplatelet drugs like aspirin and anticoagulants (blood thinners), such as warfarin, rivaroxaban, or apixaban. By interfering with the blood’s natural ability to clot, these agents cause bleeding to stop less quickly, often resulting in a larger hemorrhage. Individuals with underlying blood clotting disorders, such as thrombocytopenia, also face an elevated risk of spontaneous or recurrent bleeding episodes.
Prognosis and Warning Signs
Despite the dramatic appearance of the red patch, a subconjunctival hemorrhage is self-limiting and requires no specific treatment. The blood is naturally reabsorbed by the body over time. The resolution process typically takes between one and three weeks, depending on the size of the initial bleed. As the blood breaks down, the bright red color will change, much like a bruise fading on the skin, often shifting to shades of brown, yellow, or green before disappearing completely.
There are specific symptoms that signal the eye problem may be more serious, warranting immediate medical attention. These include significant eye pain, any noticeable loss or change in vision, or an increased sensitivity to light. If the bleeding occurred following a significant head or eye injury, or if the hemorrhages are frequent and recurrent, a comprehensive eye examination is necessary to rule out other conditions or identify an underlying systemic issue.