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Subconjunctival hemorrhage

Subconjunctival hemorrhage is a bright red patch appearing in the white of the eye. This condition is one of several disorders called red eye.

Causes

The white of the eye (sclera) is covered with a thin layer of clear tissue called the bulbar conjunctiva . A subconjunctival hemorrhage occurs when a small blood vessel breaks open and bleeds within the conjunctiva. The blood is often very visible, but since it is confined within the conjunctiva, it doesn’t move and can’t be wiped away. The problem may occur without injury. It is often first noticed when you wake up and look in a mirror.

Some things that may cause a subconjuctival hemorrhage include:

  • Sudden increases in pressure such as violent sneezing or coughing
  • Having high blood pressure or taking blood thinners
  • Rubbing the eyes
  • Viral infection
  • Certain eye surgeries

A subconjunctival hemorrhage is common in newborn infants. In this case, the condition is thought to be caused by the pressure changes across the infant's body during childbirth.

Symptoms

A bright red patch appears on the white of the eye. The patch does not cause pain and there is no discharge from the eye. Vision does not change.

Exams and Tests

The health care provider will perform a physical exam and look at your eyes.

Blood pressure should be tested. If you have other areas of bleeding or bruising, more specific tests may be needed.

Treatment

No treatment is needed. You should have your blood pressure regularly checked.

Outlook (Prognosis)

A subconjunctival hemorrhage usually goes away on its own in about 2 to 3 weeks.

Possible Complications

There are usually no complications. Rarely, a total subconjunctival hemorrhage may be a sign of a serious vascular disorder in elderly persons.

When to Contact a Medical Professional

Call your health care provider if a bright red patch appears on the white of the eye.

Prevention

There is no known prevention.

References

Bhatt U, Lagnado R, Harminder SD. Follicular conjunctivitis. In: Tasman W, Jaeger EA, eds. Duane's Clinical Ophthalmology. 2012 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol. 4, chap 7.

Crouch Jr ER, Crouch ER. Trauma: Ruptures and bleeding. In: Tasman W, Jaeger EA, eds. Duane's Clinical Ophthalmology. 2012 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol. 4, chap 61.

Knoop KJ, Dennis WR, Hedges JR. Ophthalmologic procedures. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, PA: Saunders Elsevier; 2009:chap 63.

Updated: 5/7/2013

Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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