A sudden, prominent red spot appearing on the white of your eye can be an alarming sight. This common event is medically termed a Subconjunctival Hemorrhage (SCH), which is essentially a bruise on the surface of the eye. While the bright redness may cause concern, it is a benign condition that typically does not affect vision or indicate a serious underlying problem. The spot is caused by the rupture of a tiny, fragile blood vessel located just beneath the clear outer membrane of the eye.
The Anatomy and Mechanism of the Bleeding
The dramatic appearance of the red spot is due to the specific anatomy of the eye’s outer layers. The conjunctiva is a thin, clear membrane covering the white part of the eye, known as the sclera. This membrane contains numerous small, delicate capillaries that can break easily. When a rupture occurs, blood leaks out and becomes trapped between the transparent conjunctiva and the opaque white sclera.
Because the blood is contained in this space, it cannot be quickly absorbed or drain away from the eye’s surface. This containment causes the blood to pool into a sharply demarcated, highly saturated red patch. Although the intense color often makes the condition look worse than it is, vision remains unaffected because the bleeding stays on the surface and does not involve the cornea or the interior of the eye.
Common Causes of a Burst Vessel
A burst blood vessel most frequently results from a sudden, temporary spike in venous pressure within the head and neck. These pressure increases are often caused by forceful, involuntary actions known as Valsalva maneuvers. Simple activities like a violent sneeze, a strong cough, or a bout of vomiting can generate enough momentary pressure to exceed the tensile strength of the conjunctival capillaries, leading to rupture.
Straining is another common physical trigger, including heavy lifting, pushing during a bowel movement due to constipation, or pushing during childbirth. Minor trauma to the eye can also be a cause, such as aggressive eye rubbing, incorrectly inserting contact lenses, or a slight bump. In these cases, the direct force damages the small vessels.
Certain underlying health conditions and medications can predispose an individual to this type of bleeding. Severe hypertension, or high blood pressure, is a primary systemic risk factor for spontaneous subconjunctival hemorrhage. The use of blood-thinning medications, such as aspirin or anticoagulants like warfarin, can impair the blood’s ability to clot, making vessel rupture more likely. Less common factors, including certain vascular disorders, diabetes, or blood clotting disorders, may also increase the risk of recurrent hemorrhages.
When to Seek Medical Attention
While the majority of burst blood vessels are harmless, specific “red flags” indicate the need for a professional medical evaluation. You should seek immediate care if the hemorrhage is accompanied by any change in vision, such as blurriness, double vision, or decreased visual acuity. The presence of actual pain, rather than just mild irritation or a scratchy feeling, also warrants prompt medical attention.
If the bleeding occurred following significant blunt trauma to the eye or head, examination is necessary to ensure there is no internal damage, such as a globe rupture or an orbital fracture. Another concerning sign is the presence of bleeding elsewhere in the body, such as unexplained bruising, bleeding gums, or blood in the urine, which could suggest a systemic bleeding or clotting disorder. Recurrent subconjunctival hemorrhages, especially those that happen frequently, also require a medical workup to identify underlying conditions.
Recovery and Self-Care
A benign subconjunctival hemorrhage requires no specialized medical treatment because the body naturally reabsorbs the leaked blood, much like a bruise on the skin. The healing process typically takes one to three weeks, depending on the size of the hemorrhage. The bright red spot will gradually fade, often changing color to a yellowish or brownish hue before disappearing.
During recovery, the most important self-care measure is to avoid rubbing the eye, as this can cause further irritation or re-bleeding. If you experience a mild scratchy feeling, over-the-counter lubricating eye drops, also known as artificial tears, can be used for comfort. You should continue with normal daily activities unless advised otherwise by a healthcare provider. It is recommended to avoid taking aspirin or other non-steroidal anti-inflammatory drugs, as they can potentially thin the blood and prolong healing.