A sudden, bright red spot appearing on the white of the eye is often an alarming sight. Medically, this phenomenon is called a subconjunctival hemorrhage, which is simply a broken blood vessel in the eye. While the appearance of a clearly defined, bright red patch can be dramatic, the condition is usually harmless and rarely indicates a serious problem. The blood is trapped under a transparent layer on the eye’s surface. Understanding the causes can help demystify this common occurrence and determine when medical attention is necessary.
Identifying the Condition
A subconjunctival hemorrhage occurs within the outer layers of the eye, defined by the location of the bleeding. The eye is covered by the conjunctiva, a clear, thin membrane containing numerous tiny, fragile blood vessels situated just above the sclera, the tough white outer layer of the eyeball. When a small vessel ruptures, the blood leaks out and becomes trapped between the conjunctiva and the sclera. Because the conjunctiva is transparent, the resulting spot appears as a stark, bright red stain against the white background of the eye. This condition is typically painless and does not cause any changes to vision, discharge, or light sensitivity.
Common Triggers and Physical Stressors
The most frequent causes of a broken blood vessel are acute, sudden increases in pressure within the head and chest. These actions temporarily elevate the blood pressure in the delicate vessels of the conjunctiva, causing one to rupture. This physiological effect, often known as the Valsalva maneuver, involves forceful exhalation against a closed airway. Common examples of this intense physical stress include severe bouts of coughing, aggressive sneezing, or vomiting. Straining during activities like heavy weightlifting, intense exercise, or acute constipation can also trigger the pressure spike. Minor trauma, such as vigorous rubbing of the eye, getting poked, or aggressive contact lens insertion, can also directly injure the vessel and lead to bleeding.
Underlying Systemic and Medical Factors
Certain systemic health conditions and medications can predispose an individual to subconjunctival hemorrhages. These factors do not necessarily cause the initial break but weaken the vessel walls or interfere with the body’s clotting ability. Uncontrolled or poorly managed hypertension, or high blood pressure, is a significant risk factor because it exerts chronic, elevated force against blood vessel walls, including those in the eye. Diabetes is another condition that can weaken blood vessel integrity throughout the body, making them more fragile and susceptible to rupture. Individuals taking blood-thinning medications, known as anticoagulants, are also more likely to experience these hemorrhages. Medications such as warfarin, aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) do not cause the vessel to break but, once a rupture occurs, they prevent the blood from clotting quickly, leading to a larger and more noticeable hemorrhage. In rare instances, recurrent hemorrhages may signal an underlying bleeding or blood-clotting disorder that requires specialized medical evaluation.
When to Seek Medical Attention
Most subconjunctival hemorrhages are benign and resolve entirely on their own, requiring no specific treatment. The body naturally reabsorbs the blood, much like a bruise fading on the skin, a process that typically takes one to three weeks. During healing, the bright red spot may change color, often becoming yellowish before disappearing completely. Medical consultation is important if the hemorrhage is accompanied by warning signs suggesting a more serious issue. Immediate medical evaluation is warranted if the bleeding is associated with:
- Eye pain or severe discomfort.
- Any noticeable change in vision, such as blurriness or double vision.
- Light sensitivity or eye discharge.
- Significant head or eye trauma.
Additionally, recurring subconjunctival hemorrhages without a clear, identifiable cause should prompt a visit to a healthcare provider to investigate potential underlying systemic factors.