One Cause of Red Eye – Subconjunctival Hemorrhage

“I woke up this morning and my eye was really red – like there was blood on the white of my eye!”

This is a very frightening looking condition affecting patients.  They come in with a  red eye – like a bright red blood patch on the white of their eye –  but, there is no pain, discharge or blurriness to their vision.   Sometimes the eye may feel a little bit “scratchy” or irritated but, that is usually rare.  Sometimes they are caused by trauma to the eye but, most of the time they occur without any injury sustained to the eye – they just seem to appear “out of nowhere”.

It is called a Subconjunctival Hemorrhage – or “Subconj Heme” for short.  It is caused when one of the tiny blood vessels on the white of your eye ruptures and that tiny drop of blood gets trapped between the white of your eye (the sclera) and the clear skin that covers the sclera (called the conjunctiva).  Sometimes this blood vessel breakage can be caused by a strong cough, vomiting, lifting something heavy, constipation strain, a stong sneeze etc.  This “trapped” blood usually takes about 7-14 days to clear up.  It is sort of like a bruise under the skin (but here the “skin” is the clear conjunctiva)….first the color is red and bright then over time it may turn different colors over time and become a bit yellowish before it completely clears up.

If you are on a “blood thinning” medication – it can cause the blood vessel to take a longer time to stop bleeding and a small blood spot can quickly become a much larger one due to the delay in clotting.  Many times a patient may be taking aspirin, coumadin or warfarin (these are blood thinning oral medications) or some type of herbs that can cause cause blood thinning and bleeding risks like St John’s Wort, Cayenne Pepper, Garlic, Ginger and Ginkgo.  People with high blood pressure and/or diabetes can also be at higher risk for developing a “Subconj Heme”.

It is always a good idea to go to see your eye doctor if you have a red eye and think you may  have a subconjunctival hemorrhage.  Many red eyes look alike and the doctor can tell you if you really have a subconj heme or if the redness is being caused by an eye infection or other serious condition.  If it is a subconj heme then the doctor can determine if you need to be sent for further investigation of possible blood/bleeding disorders.

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