Subconjunctival Hemorrhage

Today another common eye problem presented to the clinic. One was a 63 y.o. female who looked in the mirror and noticed her right eye was very red. There was no pain associated with this red eye and that is very typical of a subconjunctival hemorrhage. The other patient was a 6 month old boy who has had two red eyes since birth.
Both of these patients had what is known as a subconjunctival hemorrhage. The eye has several layers of thin tissue surrounding the wall of the eye. The wall is called the sclera and it is what makes our eyeball look white. The outermost thin layer surrounding the sclera is called conjunctiva and it is associated with many small blood vessels which are located just inside the conjunctiva. One of these blood vessels can break and the blood spreads out beneath the clear translucent layer of the conjunctiva and it produces a red eye. It would be like putting a drop of blood between two pieces of saran wrap or wax paper. The blood would spread out and a small drop would appear to be much larger because of the spread.

Most commonly, a hemorrhage occurs in someone who has been coughing or sneezing or performing heavy lifting. This is not usually associated with pain and often the patient notices it in the mirror or someone comments about their red eye. Depending on how much blood accumulates it can look very bad. Other serious causes such as high blood pressure or ocular tumors need to be eliminated from the diagnosis. It can also occur from an injury to the eye.
In most cases, I tell patients that the next day it may appear to be worse as the blood spreads out before beginning to reabsorb. It may take 10-14 days to clear but usually there is no damage or other problems. In most cases, eye drops are unnecessary unless the patients eye is irritated for some other reason. As usual, if this hemorrhage occurs you need to see your eye specialist immediately to make sure there is nothing more serious going on.

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