Bleeding Under Conjunctiva (Subconjunctival Hemmorhage)

Written by Helen Colledge and Matthew Solan | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

Overview

If you have bleeding under your conjunctiva (also known as a subconjunctival hemorrhage) it means that blood has collected under the transparent tissue that covers the white of your eye.

Numerous tiny blood vessels are located in the conjunctiva and in the space between the conjunctiva and the underlying sclera (the white of your eye). Occasionally one of the vessels can burst. Even a tiny amount of blood can spread out a lot in the narrow space and can make the condition appear quite alarming.

As the conjunctiva only covers the white of your eye, the central area of the eye (the cornea) is not affected. Your cornea is responsible for your sight, so any bleeding under the conjunctiva should not affect your vision.

In addition to covering the sclera, the conjunctiva also lines the insides of your eyelids. It contains many tiny glands that secrete fluid to protect and lubricate your eye.

Blood under the conjunctiva is not a dangerous condition. It usually goes away on its own within a few weeks.

What Causes Bleeding Under the Conjunctiva?

The causes for most cases of subconjunctival hemorrhage are not known, but may include any of the following:

  • accidental injury
  • surgery
  • straining and coughing
  • lifting heavy objects
  • eye rubbing
  • high blood pressure
  • bleeding disorders
  • taking certain drugs, including aspirin and steroids
  • eye infections
  • infections that are associated with a fever, such as influenza and malaria
  • certain diseases, including diabetes and systemic lupus erythematosus
  • parasite infestations
  • vitamin C deficiency

Newborn babies can occasionally develop a subconjunctival hemorrhage during the process of childbirth.

What are the Symptoms of Subconjunctival Bleeding?

Normally with this condition, only one of your eyes is red. The affected eye may feel slightly irritated. Often, there may not be any other symptoms. You should not experience any changes in your vision, or any eye pain. Your eye will probably have a patch that appears bright red, with the rest of the eye appearing normal.

Note: If you have blood in your eye after an injury to your skull, you should contact your doctor immediately. The bleeding may be from the brain, rather than just in the subconjunctiva of your eye.

What are the Risk Factors for Subconjunctival Bleeding?

Bleeding under the conjunctiva is a common condition that can occur at any age. It is thought to be equally common in both sexes and all races. The risk of experiencing this kind of bleeding increases as you get older. If you have a bleeding disorder, or if you take drugs to thin your blood, you may have a slightly higher risk.

How is it Diagnosed? Will You Need Tests?

It is important to tell your doctor if you have recently experienced any unusual bruising or bleeding, or any injuries, such as a foreign object in your eye.

Most often, if you have bleeding under your conjunctiva you will not need any tests. Your doctor will inspect your eye and check your blood pressure. In some cases, you may be asked to give a blood sample to test for any bleeding disorders. This is more likely if you have had more than one episode of bleeding under the conjunctiva, or if you have experienced other odd hemorrhages or bruises.

What are the Treatments?

Usually, no treatment is needed, as a subconjunctival hemorrhage will resolve on its own.

If your eye feels irritated, your doctor may recommend you use artificial tears several times a day. You may be advised to avoid taking any drugs that might increase the risk of bleeding, such as aspirin or warfarin (Coumadin).

If your doctor finds your condition is due to high blood pressure or a bleeding disorder, you will need further treatment for those conditions.

How can Subconjunctival Hemorrhages be Prevented?

It is not always possible to prevent subconjunctival hemorrhages. Sometimes it can help to avoid taking drugs that increase the risk of bleeding.

You should try not to rub your eyes. If you suspect there is something in your eye, it is better to flush it out with your own or artificial tears rather than using your fingers. To avoid particles entering your eyes, always wear protective goggles when recommended.

What is the Long-Term Outlook?

As the condition resolves, you may notice the area of bleeding increase in size and change color, turning yellow or green, and resembling a bruise. This is quite normal and is no cause for concern. Eventually, it should return to normal.

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