Subconjuctival hemorrhage
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subconjunctival hemorrhage patient information causes treatment red flags American Academy Ophthalmology
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A subconjunctival hemorrhage is a small bleed from a surface blood vessel beneath the clear membrane over the white of the eye. It looks like a sharply defined bright-red patch, often appears suddenly, and is usually painless with normal vision.
Common triggers
- Coughing, sneezing, vomiting, heavy lifting, constipation/straining
- Eye rubbing or a minor bump
- Sometimes no trigger is found
- More likely with high blood pressure, diabetes, aspirin/anticoagulants, or bleeding disorders
What to do
- Usually no specific treatment is needed. It clears like a bruise over about 1-3 weeks.
- Artificial tears can help if there is mild irritation.
- Do not stop prescribed blood thinners without speaking with the prescriber.
- If recurrent, arrange a routine clinician or eye examination, including a blood-pressure check and medication review.
Seek urgent eye care today if it followed a significant eye injury, or if there is eye pain, reduced/blurred vision, light sensitivity, severe headache, unequal pupils, nausea/vomiting, blood inside the colored part of the eye, or marked swelling. These features are not typical of a simple surface hemorrhage.
Textbook guidance describes the typical presentation as a bright-red eye with normal vision and no pain, resolving without treatment in 2-3 weeks; possible trauma needs assessment for deeper eye injury. Textbook of Family Medicine 9e, p. 353. The AAO patient guidance similarly notes that most cases self-resolve and artificial tears may be used for irritation.
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