Subconjunctival Hemorrhage - Cause

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What causes a subconjunctival hemorrhage?

The conjunctiva contains nerves and many small blood vessels. These blood vessels are usually barely visible but become larger and more visible if the eye is inflamed. These blood vessels are somewhat fragile and their walls break easily, resulting in a subconjunctival hemorrhage (bleeding under the conjunctiva). A subconjunctival hemorrhage appears as a bright red or dark red patch on the sclera. Most subconjunctival hemorrhages are spontaneous without an obvious cause for the bleeding from normal conjunctival blood vessels. Since most subconjunctival hemorrhages are painless, a person may discover a subconjunctival hemorrhage only by looking in the mirror. Many spontaneous subconjunctival hemorrhages are first noticed by another person seeing a red spot on the white of your eye. Rarely there may be an abnormally large or angulated blood vessel as the source of the hemorrhage.

The following can occasionally result in a spontaneous subconjunctival hemorrhage:

  • Sneezing
  • Coughing
  • Straining/vomiting
  • Increasing the pressure in the veins of the head, as in weight lifting or lying on an inversion table upside-down
  • Eye rubbing or inserting contact lenses
  • Certain infections of the outside of the eye (conjunctivitis) where a virus or a bacteria weaken the walls of small blood vessels under the conjunctiva
  • Medical disorder causing bleeding or inhibiting normal clotting

Subconjunctival hemorrhage can also be non-spontaneous and result from a severe eye infection, trauma to the head or eye, or after eye or eyelid surgery.

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See what others are saying

Comment from: dawnaj10, Female (Patient) Published: October 09

I got mine after taking Nasacort nasal spray, which has steroids. I took my first dose and found the subconjunctival hemorrhages within an hour of taking it.

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Comment from: Dasneezequeen, 25-34 Female (Patient) Published: November 20

I got subconjunctival hemorrhage from having violent fits of sneezing and coughing. Almost the entire white of my eye was red, and even before the coughing and sneezing stopped it went away. I think it is the first time it happened. It was pretty gnarly looking.

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