Subconjunctival Hemorrhage: A Patient’s Guide

Strong, sudden actions can raise the pressure in the veins of your head and neck, causing a fragile blood vessel in your eye to break. This can happen from forceful coughing, powerful sneezing, vomiting, straining during a bowel movement, or lifting heavy objects. Any activity that causes you to hold your breath and strain, known as a Valsalva maneuver, can trigger this type of bleeding.

Even mild injury can lead to a bleed. This includes vigorous eye rubbing, irritation from a contact lens, a poke to the eye, or a minor bump to the eye area. Sometimes something as simple as sleeping with your face pressed into a pillow or rubbing your eyes when you first wake up can be enough to break a small vessel.

Certain medical conditions can weaken blood vessel walls throughout your body, making them more prone to rupture. These include high blood pressure (hypertension), which is one of the most common contributing factors, as well as diabetes and diseases that affect blood vessels or clotting. If you have recurrent subconjunctival hemorrhages, your doctor may want to evaluate these underlying conditions more closely.

Medications that reduce the blood's ability to clot can make bleeding more likely, even from a minor event. Common examples include aspirin, warfarin, clopidogrel, and other anticoagulants or antiplatelet drugs. If you take these medications, you may be more prone to developing subconjunctival hemorrhages. However, you should never stop or change your medication without consulting your prescribing physician, as these drugs are often essential for managing serious health conditions.

Recent eye surgery or procedures, including cataract surgery, glaucoma procedures, or injections into the eye, can sometimes result in a subconjunctival hemorrhage. This is a known and usually harmless side effect that resolves as part of the normal healing process.

In many instances, a subconjunctival hemorrhage occurs without any clear or identifiable cause. These spontaneous cases are referred to as idiopathic and are generally not a cause for concern in healthy individuals. You might simply wake up one morning and notice the red patch without having experienced any obvious trauma or strain.

It is bleeding under the clear lining of the eye (the conjunctiva) from a broken blood vessel, which causes a painless red patch on the white of the eye. It is similar to a bruise on the skin and typically resolves on its own without treatment.

The redness usually begins to fade within a week and clears completely in one to three weeks, depending on the size of the hemorrhage. During this time, its color may change from bright red to brown or yellow as the blood is absorbed by your body. Larger hemorrhages naturally take longer to resolve than smaller ones.

No, a subconjunctival hemorrhage does not affect your vision because the bleeding is on the surface of the eye, not inside it where light is focused and processed. If you notice any vision changes along with the red patch, you should see an eye doctor right away, as this could indicate a different or more serious condition.

It is best to avoid wearing contact lenses until the hemorrhage has completely cleared to prevent further irritation and to allow your eye to heal comfortably. You can use eye makeup, but be very gentle when applying and removing it to avoid rubbing the eye or causing additional trauma to the delicate blood vessels.

Recurrent hemorrhages may be a sign of an underlying medical issue, such as uncontrolled high blood pressure, a bleeding disorder, or poorly controlled diabetes. It is important to see your eye doctor and primary physician for a comprehensive evaluation if this happens. They may recommend blood pressure monitoring, blood tests, or other diagnostic steps to identify and treat the root cause.

You can continue most normal activities, including light exercise, but it is wise to avoid heavy lifting, straining, or activities that significantly raise your blood pressure until the hemorrhage begins to heal. High-intensity workouts or powerlifting may increase the risk of the hemorrhage spreading or recurring.

While you cannot prevent all cases, managing your blood pressure, avoiding eye trauma, using proper lifting techniques, and addressing chronic health conditions can reduce your risk. If you take blood thinners, work closely with your doctor to ensure the dosage is appropriate for your needs.

You should contact your doctor if you experience any pain, light sensitivity, or changes in vision, if the redness does not start to improve after two weeks, if the hemorrhage happened after a significant injury to your head or eye, or if you develop recurrent hemorrhages without a clear explanation.