Why Is My Eye Red?Understanding Subconjunctival Hemorrhage

Seeing a bright red patch in your eye can be unsettling, but it’s usually nothing to worry about. A subconjunctival hemorrhage happens when tiny blood vessels under the clear surface of your eye break often from something as simple as a sneeze, cough, or strain. It may look dramatic, but in most cases, it’s harmless and fades on its own. However, if you have pain, vision changes, or frequent occurrences, it’s best to get it checked by an eye doctor.

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Red Spot in Your Eye? Here’s What It Means and When to Worry

Is a Subconjunctival Hemorrhage Ever an Emergency? Know the Warning Signs

While often benign, subconjunctival hemorrhage can sometimes indicate a serious underlying issue or require immediate attention due to associated symptoms. Seek emergency care in the following situations:

Eye Pain: Significant discomfort alongside blood in the eye could suggest conditions like hyphema or uveitis, requiring prompt treatment.
Persistent Bleeding: If the hemorrhage persists beyond two weeks without improvement, consult an eye care professional to investigate underlying health issues.
Vision Changes or Loss: Any changes in vision or episodes of vision loss accompanying the hemorrhage demand immediate medical attention, as they may indicate severe conditions like retinal detachment or optic nerve damage.
Recurrent Episodes: Repeated occurrences, especially in children and the elderly, can signify systemic conditions like hypertension or diabetes. Frequent episodes in children may also hint at trauma, including non-accidental injuries.
Trauma or Injury: Hemorrhages following eye injury or trauma require immediate intervention due to the risk of concurrent severe eye injuries like orbital fractures or globe rupture.
Blood in the Pupil: Blood pooled in the pupil area (hyphema) can increase intraocular pressure and harm vision, making it a medical emergency.
Pus, Swelling, or Fever: These symptoms, along with subconjunctival hemorrhage, suggest infection or inflammation, possibly conjunctivitis or cellulitis, warranting a thorough medical examination.

If you or a loved one experiences any of these emergency situations, contact us to schedule an eye exam with our eye doctors.

Key Symptoms to Watch for in a Subconjunctival Hemorrhage

A subconjunctival hemorrhage typically presents as a bright red or dark patch on the white part of the eye, caused by blood leaking from a ruptured blood vessel. Despite its alarming appearance, it usually doesn’t cause pain, vision changes, or discharge. Most people remain unaware of the hemorrhage until they look in the mirror or someone else points it out. In some cases, there might be mild irritation or a feeling of pressure in the eye. The red patch doesn’t spread but may change color as it heals, transitioning from red to yellow or green, similar to a bruise. Symptoms generally resolve within one to two weeks without treatment.

What Causes a Subconjunctival Hemorrhage? The Common Triggers

Pressure Spikes: How Sneezing, Coughing, and Straining Can Lead to Eye Bleeding

One of the most common causes of subconjunctival hemorrhage is a sudden increase in blood pressure in the small, delicate vessels of the eye. This can occur due to:

Coughing or Sneezing: These sudden, forceful actions can increase pressure in the blood vessels around the eyes.
Heavy Lifting or Straining: Physical exertion that leads to straining can also cause these tiny blood vessels to rupture.
Vomiting: The intense physical stress from vomiting can lead to a subconjunctival hemorrhage.

Injuries & Trauma: When a Blow to the Eye Causes a Blood Vessel to Burst

Direct injury to the eye, even minor ones, can result in subconjunctival hemorrhage. This includes:

Rubbing the Eyes Vigorously: Friction from rubbing the eyes too hard can cause small blood vessels to burst. Frequent eye rubbing due to allergies can weaken blood vessels over time, making them more likely to burst.
Blunt Trauma to the Eye: Accidents or incidents that involve impact to the eye area may cause hemorrhaging.

Health Conditions That Can Make Your Eyes More Prone to Bleeding

Several underlying health issues can increase the likelihood of developing a subconjunctival hemorrhage, particularly those affecting blood circulation and pressure:

High Blood Pressure (Hypertension): Chronic high blood pressure can weaken the blood vessels in the eyes, making them more prone to rupturing. According to the American Academy of Optometry, hypertension is a significant risk factor for recurrent subconjunctival hemorrhages.
Diabetes: Diabetes can lead to changes in blood vessel integrity, increasing the risk of vessel rupture in the eye.
Blood Clotting Disorders: Conditions that affect the blood’s ability to clot, such as hemophilia or the use of anticoagulants (blood thinners like aspirin or warfarin), can make the eye’s blood vessels more susceptible to bleeding.

Could Your Medication Be Causing Eye Bleeding? What to Know

Blood Thinners & Anticoagulants: How They Affect Your Eye’s Blood Vessels

Drugs such as aspirin, warfarin, and other anticoagulants decrease the blood’s ability to clot, making it easier for small blood vessels to burst.

Pain Relievers & NSAIDs: Can They Contribute to Burst Blood Vessels?

Common over-the-counter medications like ibuprofen can increase the likelihood of bleeding.

Why Did Your Eye Vessel Burst? Other Common Triggers Explained

How Aging Affects Your Eye’s Fragile Blood Vessels

As people age, their blood vessels become more fragile and more susceptible to rupturing, leading to a higher incidence of subconjunctival hemorrhages among older individuals.

Eye Surgery & Procedures: When Treatments Lead to Temporary Redness

Surgical interventions involving the eyes, such as cataract surgery, LASIK, or other procedures, can sometimes cause subconjunctival hemorrhages as a side effect of the operation.

Infections & Inflammation: Can They Cause Eye Bleeding?

Certain viral or bacterial infections may increase eye inflammation, making the blood vessels more prone to rupture.

Air Pressure Swings: How Sudden Changes Can Impact Your Eyes

Rapid changes in altitude or pressure, such as during air travel, can lead to vessel rupture.

Irritated Eyes: When Rubbing or Allergies Lead to Broken Blood Vessels

Prolonged use of contact lenses or exposure to environmental irritants like smoke or dust can strain the eyes, leading to blood vessel rupture.

Subconjunctival Hemorrhage: What Causes That Red Spot in Your Eye?

A subconjunctival hemorrhage may look alarming, but it’s usually harmless. However, some lifestyle habits and underlying health conditions can make these small blood vessel ruptures more common or more severe. Factors like frequent eye rubbing, high blood pressure, certain medications, or even sudden sneezing or coughing can contribute to these red patches in the eye. Understanding what might be causing them can help you prevent future occurrences and keep your eyes healthy.

Weakened Blood Vessels: Why Some Eyes Are More Prone to Bleeding

Aging and conditions like hypertension or diabetes can weaken blood vessels, making them prone to rupture.

How Medications Can Impact Your Eye’s Blood Vessels

Blood-thinning medications, including warfarin, aspirin, and NSAIDs, can heighten the risk of SCH even with minimal trauma.

Health Conditions That May Lead to Frequent Eye Bleeding

Conditions affecting clotting, like hemophilia, or blood vessel integrity, such as Steven-Johnson syndrome or Kaposi's sarcoma, may increase susceptibility to SCH.

Subconjunctival Hemorrhage Treatment: What Works and What Doesn’t

A subconjunctival hemorrhage usually heals on its own within one to two weeks without treatment. However, if you experience pain, vision changes, or frequent recurrences, see an eye doctor. Using artificial tears, avoiding eye rubbing, and managing health conditions can help prevent future episodes.

Simple Ways to Soothe and Support Healing

Ice packs and artificial tears can provide comfort and reduce swelling.

When to See an Eye Doctor for Ongoing Redness

If SCH persists or recurs, further testing may be needed to assess for clotting disorders or vascular issues.

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