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Subconjunctival hemorrhage

A subconjunctival hemorrhage is a bleed that occurs on the surface of the eye.  The bleed actually occurs in the conjunctiva, which is a thin clear layer of tissue and blood vessels lying over the sclera, the white area of the eye.  Subconjunctival hemorrhages can look very concerning and serious; however, most of these hemorrhages are of minimal concern to eye health and resolve quickly.

 

Causes

Subconjunctival hemorrhages are most frequently caused by heavy coughing, vomiting, or straining, high blood pressure, bleeding disorders, injury, and the use of blood thinners such as aspirin, clopidogrel, and warfarin.  Rarely, a subconjunctival hemorrhage can be caused by a mass within the orbit, the bony area surrounding the eye.  Sometimes no obvious cause can be determined. 

Treatment

In most cases where a bleed has occurred for the first time, artificial tear drops are recommended to help with any irritation, and patients are advised that the bleed will typically resolve in 2-3 weeks.  Patients may be asked to have their blood pressure checked if they are not certain of their blood pressure readings.  If the bleed is caused by a trauma, a detailed exam is performed to rule out any serious injury to the eye.  In the case of bleeds caused by trauma, patients may need follow up visits for monitoring.  Otherwise, patients are asked to return if the bleed does not resolve, or if there is any recurrence.  In instances of recurrences, a work up may be initiated to look for any bleeding disorders or orbital or conjunctival masses that may be causing the hemorrhages.