Seeing a bright red patch on the white of your eye can be alarming, but in most cases, this common condition, known as a subconjunctival hemorrhage, is harmless. Think of it as a bruise on the eye's surface. It occurs when one of the tiny blood vessels in the conjunctiva—the clear membrane covering the white part of your eye (sclera)—breaks, leaking a small amount of blood just beneath the surface. Because the blood is trapped between the conjunctiva and the sclera, it appears as a startling, vividly red spot.

What Causes a Subconjunctival Hemorrhage?

While the appearance is dramatic, the cause is usually quite simple, often resulting from a sudden increase in pressure in the head or chest. Common triggers include:

• Vigorous coughing, sneezing, or vomiting: These actions create sudden pressure.
• Straining: This can happen during bowel movements or heavy lifting.
• Eye rubbing: Excessive or hard rubbing can break fragile blood vessels.
• Trauma: A direct, minor injury to the eye.

Rarely, a subconjunctival hemorrhage can be linked to underlying health conditions such as high blood pressure, taking blood-thinning medications, or a blood-clotting disorder. If you experience frequent recurrent hemorrhages, it's important to consult with your eye care professional or general practitioner to rule out these possibilities.

Management and Treatment

The good news is that a subconjunctival hemorrhage rarely requires any treatment. There are no drops or pills that will make the blood disappear faster, and the condition is usually painless, though some people report a mild feeling of scratchiness on the eye's surface.

Since the body must reabsorb the blood, the main management is simply watchful waiting. Over a period of one to three weeks, the bright red color will typically fade, much like a bruise on the skin, often turning yellowish before it completely disappears.

To alleviate any mild irritation, you may use over-the-counter artificial tears. However, do not use medicated eye drops unless advised by an eye doctor, as they are not needed and may sometimes mask a different condition.

If the hemorrhage is accompanied by pain, a change in vision, discharge, or sensitivity to light, you should seek immediate care as this may indicate a more serious eye injury or infection. You should also book a follow-up appointment with your doctor if the hemorrhage doesn't resolve within three weeks. 

Prognosis

The prognosis for a subconjunctival hemorrhage is excellent. It is a benign condition that resolves completely without any long-term effects on your vision or eye health. While concerning to look at, this "red eye" typically signals a minor event that your body will heal on its own. Remember to avoid rubbing your eyes to prevent recurrence.

If you are concerned about your recovery, or if you are unsure whether your symptoms are a simple subconjunctival hemorrhage or something more serious, we recommend scheduling an appointment at Eye Associates by calling (210) 340-1212.