Blood spots in the eye are almost always caused by a tiny blood vessel bursting in the clear tissue that covers the white of your eye. This tissue, called the conjunctiva, sits over the sclera (the white part) and lines the inside of your eyelids. When one of its small blood vessels breaks, blood leaks into the space between the conjunctiva and the sclera, creating a bright red patch that looks alarming but is typically painless and harmless. The medical term is subconjunctival hemorrhage, and it’s remarkably common: roughly 1 in 167 people experience one in any given year.
Common Triggers That Break the Vessel
Most blood spots appear after something briefly spikes the pressure in the tiny veins of your eye. The most frequent culprits are everyday physical actions you might not think twice about:
- Coughing or sneezing, especially during a cold or allergy flare
- Straining, such as heavy lifting, bearing down during a bowel movement, or intense exercise
- Vomiting
- Rubbing your eye too hard
- Minor trauma, like bumping or poking the eye
Any of these can generate enough force to rupture a fragile capillary. In many cases, though, you won’t be able to pinpoint what caused it. You might simply wake up, look in the mirror, and notice a red spot that wasn’t there the night before.
Health Conditions That Raise Your Risk
While a one-time blood spot is usually nothing to worry about, certain chronic health conditions make the blood vessels in your eye more vulnerable to breaking. High blood pressure and diabetes are the two most notable. Both damage small blood vessels over time, making them more fragile and more likely to rupture from minor pressure changes. People over 65, particularly those living with one or both of these conditions, have the highest risk.
A large population study in Taiwan tracked cases over more than a decade and found the incidence peaks sharply in the 60 to 69 age group, at roughly 136 per 10,000 people per year. That’s nearly four times the rate seen in teenagers and young adults. Women also develop blood spots slightly more often than men.
Medications That Make Bleeding Easier
Blood-thinning medications and drugs that reduce clotting can make a subconjunctival hemorrhage more likely, or make the resulting blood spot larger. Common examples include aspirin, prescription anticoagulants, and antiplatelet drugs. These medications don’t cause the vessel to break, but they make it harder for the body to plug the leak quickly, so more blood pools under the surface. If you take any blood-thinning medication and notice frequent blood spots, it’s worth mentioning to your doctor, though you should never stop a prescribed blood thinner on your own.
How It Heals
The blood trapped under the conjunctiva can’t be rinsed or wiped away. Your body reabsorbs it gradually, the same way a bruise fades on your skin. Most blood spots clear up within a few days to a few weeks, depending on how much blood leaked out. A large spot may shift in color as it heals, moving from bright red to darker red, then sometimes yellowish or greenish before disappearing entirely.
No treatment is needed in most cases. If the spot makes your eye feel scratchy or dry, over-the-counter artificial tears can help soothe the irritation. Avoid rubbing the eye, which could delay healing or cause a new bleed.
Blood Spot vs. Bleeding Inside the Eye
A subconjunctival hemorrhage sits on the surface of the eye and does not affect your vision. It’s important to distinguish it from a hyphema, which is bleeding inside the front chamber of the eye, between the cornea and the iris. A hyphema often follows a direct blow to the eye and can look like a layer of blood pooling at the bottom of the colored part of your eye, with darker blood settling below and brighter blood above. Unlike a surface blood spot, a hyphema can cause blurry vision, light sensitivity, and pain, and it requires prompt medical evaluation because it carries a risk of complications.
If your blood spot comes with vision changes, eye pain, or visible bleeding that appears to be behind the colored part of the eye rather than on the white surface, that’s a different situation entirely.
When Blood Spots Keep Coming Back
A single episode rarely signals anything serious. Recurrent blood spots are a different story. If you notice them happening repeatedly, it may point to an underlying issue with blood clotting, uncontrolled blood pressure, or, in rare cases, a vascular abnormality. A history of easy bruising elsewhere on the body or frequent nosebleeds alongside recurring eye bleeds is a pattern that warrants blood work to check your clotting function. If the hemorrhage fails to resolve within a reasonable timeframe or keeps returning, a more thorough workup is appropriate to rule out systemic causes.