Noticing a bright red patch in what is usually a white area of the eye can be unnerving. It may indicate a subconjunctival hemorrhage, in which a blood vessel in the conjunctiva (the clear layer covering the white sclera of the eye) breaks and blood collects in the area.
This may occur right after a coughing or sneezing attack, vigorously rubbing your eyes, straining to lift a heavy object, intense exercise, or some other kind of trauma. Any of these can leave you with an unsightly blood spot that has you wondering what happened.
Even healthcare professionals may not be able to determine the cause of a subconjunctival hemorrhage. The good news is that most cases are harmless, do not cause pain, and will go away without intervention.
This article will discuss broken blood vessels in the white of the eye, what they look like, causes, what to expect, and when to see a healthcare provider.
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What Is a Subconjunctival Hemorrhage?
"Subconjunctival hemorrhage" is the medical term for tiny blood vessels in the outer eye that have broken.
The conjunctiva is the clear layer that covers the sclera and the lining of the upper and lower lids. Beneath this clear layer are the blood vessels that can sometimes break, causing the subconjunctival hemorrhage.
Blood from the broken blood vessel collects on the sclera. The white, protective sclera reaches from the front of the eye, next to the cornea (the clear dome of the front of the eye), to the back of the eye where the optic nerve is.
Is a Broken Blood Vessel in the Eye Serious?
Although seeing blood in any part of your eye can be alarming, a subconjunctival hemorrhage is typically not serious and will resolve on its own. In this condition, the blood is found on the white part of the eye.
Blood in the center of the eye, between the colored iris and the clear cornea, is known as a hyphema and is of concern. It is usually caused by trauma and is a medical emergency. It hurts and can result in permanent vision issues.
A blood spot seen on the white of the eye is usually not an indication of a more serious condition, although it can be associated with diabetes, high blood pressure, and rare clotting disorders.
However, blood vessel changes deeper in the eye, on the light-sensitive retina, are a concern for conditions affecting the retina and can show an increased risk for stroke. These are only detected when an eye-care professional, such as an eye doctor (ophthalmologist or optometrist), performs a dilated eye exam.
What Does a Broken Blood Vessel in the Eye Look Like?
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A subconjunctival hemorrhage may initially appear as a bright red spot on the white of your eye. The spot remains in the same place since it is trapped under the conjunctiva. It does not seep from the eye.
Despite the alarming appearance, it does not usually hurt, and vision is also unaffected. You may only notice it when you look in the mirror. Sometimes, you will feel slight eye irritation.
Over time, as the blood breaks down, the red patch may begin to turn bluish and yellow, and the borders may become less distinct.
What Causes a Broken Blood Vessel in the Eye?
A broken blood vessel in one eye may appear to come out of nowhere, but there usually is a trigger. Some underlying causes and conditions that may heighten risk are:
- High blood pressure
- Complication from recent eye surgery
- Trauma
- Wearing contact lenses
- Prolonged sneezing or coughing
- Pushing during a vagin*l delivery
- Straining to eliminate stool
- Conjunctival inflammation
- Atherosclerosis (fatty deposits in the arteries)
- Diabetes
Physical stress (in the form of straining) may cause a popped blood vessel in the eye, but psychological stress is not considered a direct cause.
If you have a blood spot in the eye, it is usually impossible to determine the cause or prevent it from happening again. But if you have a systemic condition (one affecting the entire body) like high blood pressure, diabetes, or atherosclerosis, it is wise to consult a healthcare provider and manage the condition.
All subconjunctival hemorrhages are also not the same. Healthcare providers usually divide these into two groups—traumatic and spontaneous.
Traumatic
Trauma from medical procedures or physical injury can cause a subconjunctival hemorrhage. This can happen if you've recently undergone eye surgery, such as cataract removal or refractive laser correction with laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK), or eye injections.
It can also occur if you experience a blow to the eye, such as while playing sports, in a motor vehicle accident, or getting in a fight. But even rubbing the eye can be the source of the trauma.
Spontaneous
A blood spot in the eye can also appear seemingly out of nowhere. Your eye is clear one minute, and the next, there's a blood spot. Usually, this is linked to a sudden rise in pressure in the head related to lifting something heavy, vomiting, or coughing extensively.
If you are taking medication such as a medication that thins the blood, like aspirin, you may also be at greater risk of this occurring.
A Word From Verywell
Most cases we see in the office are benign (not harmful), resulting from inadvertent rubbing of the eye, lifting, and bending. Strangely enough, most patients complain of a pain in the eye when the initial vessel breaks.
— ANDREW GREENBERG, MD, MEDICAL EXPERT BOARD
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Are There Treatment Options?
In many cases, a subconjunctival hemorrhage will heal over a few weeks without any medical intervention. If you feel any irritation, you may use artificial tears or reach for an ice pack.
If you need pain relief, avoid taking aspirin since this can be linked to more bleeding. Instead, use Tylenol (acetaminophen). As acetaminophen may be included in cold and flu medications and combination pain relievers, make sure not to take more than one acetaminophen product at a time. Too much acetaminophen can cause complications.
If you get eye injections for a retinal condition, the ophthalmologist may try medications like oxymetazoline to prevent further subconjunctival hemorrhages and improve comfort.
In cases in which subconjunctival hemorrhage is due to trauma or if there's concern that the light-sensitive retina may be involved, it's important to consult an eye specialist who can ensure that there isn't unseen damage to the eye.
How Long Does It Take to Go Away?
While you may hope the subconjunctival hemorrhage will resolve instantaneously, the truth is that it may take anywhere from a few days to several weeks for the blood to reabsorb, depending on whether you're contending with a small blood spot or a larger one.
When to Contact a Healthcare Provider
Although, in most cases, a subconjunctival hemorrhage will heal on its own, there are times when you should reach out to an eye-care provider, such as if any of the following occurs:
- You notice thick discharge from your eye, redness, swelling, or other indications of an infection, such as a fever.
- Your vision starts to change.
- You notice blood in the center of your eye over the pupil (dark center) or colored iris.
- The blood spot is taking longer than expected to go away.
Summary
If you suddenly notice a blood spot in the white of your eye, this may be due to a subconjunctival hemorrhage. While these may temporarily affect your appearance, they are not painful and typically resolve on their own.
A subconjunctival hemorrhage can be caused by anything from high blood pressure to a sudden coughing or sneezing fit. Usually, it will go away within a couple of weeks. But if the blood spot persists, be sure to get it checked promptly.
