Subconjunctival Hemorrhage

A subconjunctival hemorrhage is a medical condition characterized by the sudden appearance of blood underneath the conjunctiva, which is the clear membrane covering the white part of the eye (sclera). This condition occurs when a small blood vessel in the conjunctiva breaks and bleeds, causing blood to leak into the space between the conjunctiva and the sclera.

Causes

Subconjunctival hemorrhages can be caused by a variety of factors, including:

• Increased pressure or strain on the eyes, such as during heavy lifting, coughing, or sneezing
• Trauma to the eye, such as a blow to the eye or a foreign object in the eye
• Bleeding disorders, such as hemophilia or thrombocytopenia
• High blood pressure (hypertension)
• Certain medications, such as anticoagulants or antiplatelet agents
• Aging, as the conjunctiva and its blood vessels become more fragile with age

Symptoms

The primary symptom of a subconjunctival hemorrhage is the sudden appearance of a bright red patch on the white part of the eye. This patch may be small or large, depending on the amount of bleeding that has occurred. Other symptoms may include:

• Mild discomfort or irritation in the affected eye
• A feeling of grittiness or dryness in the eye
• Blurred vision, although this is rare

Diagnosis

A subconjunctival hemorrhage is typically diagnosed through a physical examination of the eye. A healthcare provider may use a slit lamp microscope to examine the conjunctiva and sclera in more detail. In some cases, additional tests may be ordered to rule out underlying conditions that may have contributed to the hemorrhage.

Treatment

In most cases, subconjunctival hemorrhages do not require treatment and will resolve on their own within 1-3 weeks. However, if the hemorrhage is large or if there are underlying conditions that need to be addressed, treatment may include:

• Applying cold compresses to reduce swelling and discomfort
• Using artificial tears to lubricate the eye and reduce irritation
• Avoiding heavy lifting, bending, or straining
• Managing underlying conditions, such as high blood pressure or bleeding disorders

Complications

In rare cases, a subconjunctival hemorrhage can lead to complications, such as:

• Recurrent hemorrhages
• Scarring of the conjunctiva
• Infection of the eye (endophthalmitis)

Prevention

To reduce the risk of developing a subconjunctival hemorrhage, individuals can take the following steps:

• Avoid heavy lifting or straining
• Manage underlying conditions, such as high blood pressure or bleeding disorders
• Avoid rubbing the eyes
• Wear protective eyewear when engaging in activities that may pose a risk to the eyes