A sudden patch of bright red on the white of the eye can be alarming, but this common condition, known as a subconjunctival hemorrhage (SCH), is typically harmless. It occurs when one of the tiny blood vessels under the clear membrane covering the eye, the conjunctiva, ruptures. The blood leaks out but remains trapped in a small, visible area, similar to a bruise. The condition usually resolves on its own.
Identifying the Appearance of the Burst Vessel
A subconjunctival hemorrhage presents as a distinct area of bright red blood against the white sclera of the eye. The blood is trapped between the conjunctiva and the underlying sclera, preventing it from spreading or being wiped away. The size can range from a small spot to a patch covering the entire white of the eye, making the appearance seem more severe than the condition is.
A key differentiating factor is the lack of associated symptoms beyond the visual presence of blood. The event is typically painless, though some individuals report a mild gritty or scratchy feeling on the eye’s surface. The hemorrhage does not affect the cornea or interior structures, meaning vision remains clear and unaffected. The absence of pain, discharge, or changes in visual acuity confirms that the issue is a benign surface bleed.
Common Triggers and Risk Factors
The rupture of these small conjunctival vessels often results from a sudden increase in pressure within the veins of the head and neck. Common physical triggers involve intense straining, such as during violent coughing, sneezing, or vomiting. Other instances include heavy lifting, aggressive rubbing of the eyes, or straining associated with constipation. This abrupt rise in venous pressure overwhelms the vessel walls, leading to the leak of blood.
Certain systemic conditions and medications can compromise vascular integrity or affect blood clotting, increasing the risk of an SCH occurring spontaneously. High blood pressure (hypertension) and diabetes are risk factors, especially in older adults. Anticoagulant or antiplatelet medications, such as aspirin or warfarin, also make a person more susceptible to these bleeding episodes. Recurrent hemorrhages without obvious physical triggers should prompt a review of these underlying systemic factors.
Immediate Steps and At-Home Monitoring
No specific treatment is necessary for a subconjunctival hemorrhage, as the body naturally reabsorbs the blood. Similar to a bruise, the blood is broken down and cleared away over one to three weeks. The healing time depends primarily on the initial size of the hemorrhage.
During the resolution process, avoid actions that could worsen irritation or cause further bleeding. Avoid rubbing the eye, as this can delay healing or cause additional trauma. If dryness or irritation occurs, over-the-counter artificial tears may be used for lubrication and comfort. As the blood is absorbed, the bright red patch will change color, often shifting to a yellowish or greenish tint before disappearing completely.
Warning Signs That Require Professional Care
While most subconjunctival hemorrhages are isolated and harmless events, certain accompanying symptoms require immediate professional medical evaluation. A doctor should be consulted if the eye bleed is accompanied by significant pain, which is not a typical symptom of a simple SCH. Any change in vision, such as blurriness, double vision, or partial loss of sight, indicates a more serious condition is likely present.
The presence of a thick discharge, swelling around the eye, or a fever alongside the hemorrhage may suggest an underlying infection. Immediate medical attention is necessary if the burst vessel resulted from significant blunt trauma to the head or eye. A medical professional must rule out more severe injuries, such as a hyphema (blood collecting inside the front of the eye) or an orbital fracture. Recurrent hemorrhages, or those occurring with other signs of easy bruising or bleeding elsewhere, warrant a full medical workup to screen for undiagnosed systemic issues.